Provider Demographics
NPI:1891560637
Name:WELLER, DANIEL WEBSTER (RN)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:WEBSTER
Last Name:WELLER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6367 NW AIRPARK CT
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-9364
Mailing Address - Country:US
Mailing Address - Phone:360-908-0643
Mailing Address - Fax:
Practice Address - Street 1:6367 NW AIRPARK CT
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-9364
Practice Address - Country:US
Practice Address - Phone:360-908-0643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00164138163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health