Provider Demographics
NPI:1891782975
Name:CANFIELD, DANIEL J (DO)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:J
Last Name:CANFIELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1020 ANDERSON DR
Mailing Address - Street 2:STE 205
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-1055
Mailing Address - Country:US
Mailing Address - Phone:360-533-6038
Mailing Address - Fax:360-538-0807
Practice Address - Street 1:1020 ANDERSON DR
Practice Address - Street 2:STE 205
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-1055
Practice Address - Country:US
Practice Address - Phone:360-533-6038
Practice Address - Fax:360-538-0807
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAOP00001772207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1115955Medicaid
WAAB29553Medicare ID - Type Unspecified
H65263Medicare UPIN