Provider Demographics
NPI:1831150358
Name:NEWELL, DANIEL DAHLBERG (LAT ,ATC, CSCS)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:DAHLBERG
Last Name:NEWELL
Suffix:
Gender:M
Credentials:LAT ,ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18309 72ND AVE W
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-5511
Mailing Address - Country:US
Mailing Address - Phone:425-418-1648
Mailing Address - Fax:
Practice Address - Street 1:18309 72ND AVE W
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-5511
Practice Address - Country:US
Practice Address - Phone:425-418-1648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-01
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0705021512255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer