Provider Demographics
NPI:1588497739
Name:DAN TOLSON MD PLLC
Entity type:Organization
Organization Name:DAN TOLSON MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-998-7529
Mailing Address - Street 1:22601 138TH AVE E
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-7215
Mailing Address - Country:US
Mailing Address - Phone:580-919-0601
Mailing Address - Fax:
Practice Address - Street 1:22601 138TH AVE E
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-7215
Practice Address - Country:US
Practice Address - Phone:425-998-7529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities