Provider Demographics
NPI:1396818324
Name:NELSON, DANIEL L (DC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:NELSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3216 NE 45TH PL
Mailing Address - Street 2:STE 117
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4093
Mailing Address - Country:US
Mailing Address - Phone:206-641-7595
Mailing Address - Fax:206-641-7596
Practice Address - Street 1:3216 NE 45TH PL
Practice Address - Street 2:STE 117
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4093
Practice Address - Country:US
Practice Address - Phone:206-641-7595
Practice Address - Fax:206-641-7596
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002066111NR0400X, 111NS0005X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NX0800XChiropractic ProvidersChiropractorOrthopedic