Provider Demographics
NPI:1356714984
Name:CALHOON-FISCHER, DANIELLE
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:CALHOON-FISCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-2311
Mailing Address - Country:US
Mailing Address - Phone:712-301-6763
Mailing Address - Fax:
Practice Address - Street 1:15965 NE 85TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3593
Practice Address - Country:US
Practice Address - Phone:425-882-9065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60606643225700000X
IA006183225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist