Provider Demographics
NPI:1972845857
Name:CALDWELL, DAN W II (HAD)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:W
Last Name:CALDWELL
Suffix:II
Gender:M
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 SE SUNNYSIDE RD
Mailing Address - Street 2:SUITE 300-N
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-5738
Mailing Address - Country:US
Mailing Address - Phone:503-659-5115
Mailing Address - Fax:503-659-5968
Practice Address - Street 1:18747 N REEMS RD
Practice Address - Street 2:SUITE 540
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-8645
Practice Address - Country:US
Practice Address - Phone:623-214-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHAD4325237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist