Provider Demographics
NPI:1982389904
Name:ROSS, DANIEL (LSWAIC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:ROSS
Suffix:
Gender:M
Credentials:LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9515 INTERLAKE AVE N APT 306
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-3360
Mailing Address - Country:US
Mailing Address - Phone:512-569-4880
Mailing Address - Fax:
Practice Address - Street 1:16715 AURORA AVE N STE 102
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-5310
Practice Address - Country:US
Practice Address - Phone:206-546-9766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor