Provider Demographics
NPI:1366160327
Name:ROOD, DANIELLE A (PA-C)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:A
Last Name:ROOD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DANI
Other - Middle Name:A
Other - Last Name:ROOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:14816 121ST ST NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98329-5073
Mailing Address - Country:US
Mailing Address - Phone:419-367-4481
Mailing Address - Fax:
Practice Address - Street 1:14816 121ST ST NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98329-5073
Practice Address - Country:US
Practice Address - Phone:419-367-4481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant