Provider Demographics
NPI:1194743732
Name:NEHLS, DANIEL G (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:G
Last Name:NEHLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1708 YAKIMA AVE
Mailing Address - Street 2:STE 105
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-5307
Mailing Address - Country:US
Mailing Address - Phone:253-426-4420
Mailing Address - Fax:253-426-4383
Practice Address - Street 1:1708 YAKIMA AVE
Practice Address - Street 2:STE 105
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-5307
Practice Address - Country:US
Practice Address - Phone:253-426-4420
Practice Address - Fax:253-426-4383
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00030744207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8939077OtherSTATE CRIME VICTIMS
WV1082510Medicaid
WAP00179318OtherRAILROAD
WA0188511OtherSTATE L&I
WV1082510Medicaid
WA0188511OtherSTATE L&I
WAP00179318OtherRAILROAD