Provider Demographics
NPI:1720085947
Name:LATTIN, DANIEL EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:EDWARD
Last Name:LATTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5901 N LIDGERWOOD ST
Mailing Address - Street 2:#117
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-1122
Mailing Address - Country:US
Mailing Address - Phone:509-483-9419
Mailing Address - Fax:509-483-7344
Practice Address - Street 1:5901 N LIDGERWOOD ST
Practice Address - Street 2:#117
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-1122
Practice Address - Country:US
Practice Address - Phone:509-483-9419
Practice Address - Fax:509-483-7344
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-01
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00020383207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1008846Medicaid
WA1008846Medicaid