Provider Demographics
NPI:1891827101
Name:SIMS, DANIEL (PT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:SIMS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6564 SE LAKE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-2138
Mailing Address - Country:US
Mailing Address - Phone:503-236-2303
Mailing Address - Fax:503-236-2614
Practice Address - Street 1:6564 SE LAKE RD STE 101
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-2138
Practice Address - Country:US
Practice Address - Phone:503-236-2303
Practice Address - Fax:503-236-2614
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORND1096175F00000X
ORPT1994208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No175F00000XOther Service ProvidersNaturopath