Provider Demographics
NPI:1598586695
Name:ELLIOTT, DANIEL MARK JR (MA: LMHC (INTERN))
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:MARK
Last Name:ELLIOTT
Suffix:JR
Gender:M
Credentials:MA: LMHC (INTERN)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 S 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-1825
Mailing Address - Country:US
Mailing Address - Phone:425-344-6420
Mailing Address - Fax:
Practice Address - Street 1:8656 W GAGE BLVD STE 106
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7145
Practice Address - Country:US
Practice Address - Phone:509-578-0005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program