Provider Demographics
NPI:1538138649
Name:PAREDES, DANIEL RUIZ (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:RUIZ
Last Name:PAREDES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DANIEL
Other - Middle Name:RUIZ
Other - Last Name:PAREDES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9601 STEILACOOM BLVD SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-7213
Mailing Address - Country:US
Mailing Address - Phone:253-756-3966
Mailing Address - Fax:253-756-2963
Practice Address - Street 1:9601 STEILACOOM BLVD SW
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98498-7213
Practice Address - Country:US
Practice Address - Phone:253-582-8900
Practice Address - Fax:253-756-2879
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML200051002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB24675Medicare PIN
WAH49831Medicare UPIN