Provider Demographics
NPI:1386061695
Name:RODIA, DANIELL (NC60272736)
Entity type:Individual
Prefix:
First Name:DANIELL
Middle Name:
Last Name:RODIA
Suffix:
Gender:F
Credentials:NC60272736
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15424 9TH AVE SW APT 6
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2156
Mailing Address - Country:US
Mailing Address - Phone:206-310-0305
Mailing Address - Fax:
Practice Address - Street 1:15424 9TH AVE SW APT 6
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2156
Practice Address - Country:US
Practice Address - Phone:206-310-0305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANC60272736374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide