Provider Demographics
NPI:1720493117
Name:O'CONNELL, DANIELLE (LMP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 SW BARTON ST
Mailing Address - Street 2:SUITE E26
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-3948
Mailing Address - Country:US
Mailing Address - Phone:206-937-7726
Mailing Address - Fax:
Practice Address - Street 1:2600 SW BARTON ST
Practice Address - Street 2:SUITE E26
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-3948
Practice Address - Country:US
Practice Address - Phone:206-937-7726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60466625225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist