Provider Demographics
NPI:1871646653
Name:BARNARD, MICHAEL DANA (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DANA
Last Name:BARNARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-3415
Mailing Address - Country:US
Mailing Address - Phone:360-426-9870
Mailing Address - Fax:360-426-9878
Practice Address - Street 1:421 N 3RD ST
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-3415
Practice Address - Country:US
Practice Address - Phone:360-426-9870
Practice Address - Fax:360-426-9878
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD27795207X00000X
ORMD22226207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1058999Medicaid
WA200754Medicare ID - Type Unspecified
WA1058999Medicaid