Provider Demographics
NPI:1972585222
Name:MCNABB, DANIEL JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JAMES
Last Name:MCNABB
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1509
Mailing Address - Street 2:
Mailing Address - City:BUCKLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98321-1509
Mailing Address - Country:US
Mailing Address - Phone:360-829-2125
Mailing Address - Fax:360-829-5313
Practice Address - Street 1:135 JEFFERSON AVE
Practice Address - Street 2:SUITE L
Practice Address - City:BUCKLEY
Practice Address - State:WA
Practice Address - Zip Code:98321-1509
Practice Address - Country:US
Practice Address - Phone:360-829-2125
Practice Address - Fax:360-829-5313
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002824111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG001002692Medicare ID - Type Unspecified