Provider Demographics
NPI:1720895519
Name:ARON DANIELS LLC
Entity type:Organization
Organization Name:ARON DANIELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARON
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:408-497-5683
Mailing Address - Street 1:1817 NE WEIDLER ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-1491
Mailing Address - Country:US
Mailing Address - Phone:408-497-5683
Mailing Address - Fax:888-388-2469
Practice Address - Street 1:333 NE HANCOCK ST STE 13
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-3941
Practice Address - Country:US
Practice Address - Phone:408-497-5683
Practice Address - Fax:888-388-2469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center