Provider Demographics
NPI:1114396736
Name:PRATT, DANIEL ALLAN (PSYD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ALLAN
Last Name:PRATT
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9125 BRIDGEPORT WAY SW STE 102
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2448
Mailing Address - Country:US
Mailing Address - Phone:253-652-5339
Mailing Address - Fax:253-363-9163
Practice Address - Street 1:9125 BRIDGEPORT WAY SW STE 102
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-2448
Practice Address - Country:US
Practice Address - Phone:253-652-5339
Practice Address - Fax:253-363-9163
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60587903103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical