Provider Demographics
NPI:1285696880
Name:WUTHRICH, DANIEL AARON (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:AARON
Last Name:WUTHRICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 N DIVISION ST
Mailing Address - Street 2:STE 201
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-4939
Mailing Address - Country:US
Mailing Address - Phone:253-939-1230
Mailing Address - Fax:253-735-1211
Practice Address - Street 1:202 N DIVISION ST
Practice Address - Street 2:STE 201
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-4939
Practice Address - Country:US
Practice Address - Phone:253-939-1230
Practice Address - Fax:253-735-1211
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00031931207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0280793OtherSTATE L&I
WA0280783OtherSTATE L&I
WA0301024OtherCONSOLIDATED L&I
WA8236143Medicaid
WAG8914770OtherMEDIXARE
WA0280795OtherSTATE L&I
WA8804453Medicare ID - Type Unspecified
WA0301024OtherCONSOLIDATED L&I
WA8236143Medicaid