Provider Demographics
NPI:1922587914
Name:MROZEK, DANIELE NICOLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DANIELE
Middle Name:NICOLE
Last Name:MROZEK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15429 216TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98077-7781
Mailing Address - Country:US
Mailing Address - Phone:425-681-3032
Mailing Address - Fax:
Practice Address - Street 1:1218 N DIVISION AVE STE 102
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-5054
Practice Address - Country:US
Practice Address - Phone:208-255-6693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist