Provider Demographics
NPI:1881834802
Name:SILLITO, DANIEL DERROL (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:DERROL
Last Name:SILLITO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14514 81ST AVE E
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375-8419
Mailing Address - Country:US
Mailing Address - Phone:253-845-4655
Mailing Address - Fax:253-445-7902
Practice Address - Street 1:5511 112TH AVE E
Practice Address - Street 2:SUITE B
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-5903
Practice Address - Country:US
Practice Address - Phone:253-845-4655
Practice Address - Fax:253-845-1052
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60072154111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor