Provider Demographics
NPI:1588408256
Name:O'BRIEN, DANIELLE (BSPTA)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:BSPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 234TH ST NE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-7698
Mailing Address - Country:US
Mailing Address - Phone:360-547-2301
Mailing Address - Fax:
Practice Address - Street 1:10530 19TH AVE SE STE 101
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-4282
Practice Address - Country:US
Practice Address - Phone:425-357-1790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60301004208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation