Provider Demographics
NPI:1891467510
Name:DANIEL, TRICIA DANIELLE (RN, CCM, WWCP)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:DANIELLE
Last Name:DANIEL
Suffix:
Gender:F
Credentials:RN, CCM, WWCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 244
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98041-0244
Mailing Address - Country:US
Mailing Address - Phone:206-280-8963
Mailing Address - Fax:206-420-5591
Practice Address - Street 1:15600 116TH AVE NE UNIT R3
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-4169
Practice Address - Country:US
Practice Address - Phone:206-280-8963
Practice Address - Fax:206-420-5591
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00137293163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management