Provider Demographics
NPI:1659872778
Name:MYERS, DANAN LEE
Entity Type:Individual
Prefix:DR
First Name:DANAN
Middle Name:LEE
Last Name:MYERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7604 CONCORD LN NE STE B104
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-4171
Mailing Address - Country:US
Mailing Address - Phone:916-205-5205
Mailing Address - Fax:
Practice Address - Street 1:7604 CONCORD LN NE STE B104
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311-4171
Practice Address - Country:US
Practice Address - Phone:916-205-5205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician