Provider Demographics
NPI:1689705451
Name:DELP, DANIEL EARLE (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:EARLE
Last Name:DELP
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 LOWDEN GARDENA RD
Mailing Address - Street 2:
Mailing Address - City:TOUCHET
Mailing Address - State:WA
Mailing Address - Zip Code:99360-9632
Mailing Address - Country:US
Mailing Address - Phone:509-529-7047
Mailing Address - Fax:
Practice Address - Street 1:1280 LOWDEN GARDENA RD
Practice Address - Street 2:
Practice Address - City:TOUCHET
Practice Address - State:WA
Practice Address - Zip Code:99360-9632
Practice Address - Country:US
Practice Address - Phone:509-529-7047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10002807363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical