Provider Demographics
NPI:1881252575
Name:WRIGHT, DANE DARRYL LEE (MS, MPA, CPC)
Entity type:Individual
Prefix:
First Name:DANE
Middle Name:DARRYL LEE
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MS, MPA, CPC
Other - Prefix:
Other - First Name:DARRYL
Other - Middle Name:LEE
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, MPA, CPC
Mailing Address - Street 1:419 S 2ND ST STE C
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2017
Mailing Address - Country:US
Mailing Address - Phone:206-225-7580
Mailing Address - Fax:
Practice Address - Street 1:419 S 2ND ST STE 2
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2234
Practice Address - Country:US
Practice Address - Phone:206-225-7580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60975593101Y00000X
WA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor