Provider Demographics
NPI:1669758868
Name:SWEET, DANIEL COLIN (LMP)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:COLIN
Last Name:SWEET
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 525
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-0525
Mailing Address - Country:US
Mailing Address - Phone:360-927-1460
Mailing Address - Fax:
Practice Address - Street 1:3410 WOBURN ST
Practice Address - Street 2:SUITE #202
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-5621
Practice Address - Country:US
Practice Address - Phone:360-752-0061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60251400225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist