Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DE00007911 | WA |
NPI | 1003902990 |
---|---|
Provider Name | Daniel W Skinner |
First Address | Spokane Valley, WA 99216-1049 |
Second Address | Spokane Valley, WA 99216-1049 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
132958 | L&I (01) | WA |
5026224 | (05) | WA |
57911 | WDS (01) | WA |
8926698 | VICTIMS OF CRIME (01) | WA |
AB11446 | (02) | WA |