Provider Demographics
NPI:1710482252
Name:GALLAGHER, FRANK DANIEL (SUDP)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:DANIEL
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:SUDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1116 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2831
Mailing Address - Country:US
Mailing Address - Phone:206-323-0930
Mailing Address - Fax:206-323-0933
Practice Address - Street 1:1221 FRASER ST STE E101
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-5844
Practice Address - Country:US
Practice Address - Phone:360-714-8180
Practice Address - Fax:360-715-2915
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP60837763101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)