Provider Demographics
NPI:1912079914
Name:DANFORTH, WILLIAM (ARNP, CS, CWCN)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:DANFORTH
Suffix:
Gender:M
Credentials:ARNP, CS, CWCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11809 SE 66TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-6410
Mailing Address - Country:US
Mailing Address - Phone:425-443-6232
Mailing Address - Fax:
Practice Address - Street 1:500 5TH AVE # 6W
Practice Address - Street 2:JHS-KCCF
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2332
Practice Address - Country:US
Practice Address - Phone:206-296-1798
Practice Address - Fax:206-296-1771
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006454363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9642984Medicaid
WAS90590Medicare UPIN