Provider Demographics
NPI:1790855799
Name:SUN, DANNY DA-NIE (MD)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:DA-NIE
Last Name:SUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:145 105TH AVE SE
Mailing Address - Street 2:11
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6254
Mailing Address - Country:US
Mailing Address - Phone:425-443-7211
Mailing Address - Fax:425-257-9817
Practice Address - Street 1:3229 HOYT AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-6404
Practice Address - Country:US
Practice Address - Phone:425-257-9880
Practice Address - Fax:425-257-9817
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00035697208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8019739Medicaid
WAAB02580Medicare ID - Type Unspecified
WA8019739Medicaid