Fullmer, Daniel Richards

Fullmer, Daniel Richards is an individual health care provider with primary practice located at 19020 33Rd Ave W Ste 210 , Lynnwood WA 98036-4748. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Fullmer, Daniel Richards can be contacted via phone (425) 563-1500.

Contact Information

Primary practice address
19020 33Rd Ave W Ste 210 Lynnwood WA 98036-4748
Phone: (425) 563-1500
Fax: (425) 563-1501
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X M-12249 Idaho
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD00049079 Washington

Profile Details

NPI number 1114994738
LBN Legal business name Fullmer, Daniel Richards
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2006
Last updated Apr 12th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114994738 NPPES
Washington Other 0285030 L&I-RADIA REST OF WA
Washington Other 0377766 L&I-RADIA REST OF WA
Washington MEDICAID 1114994738 L&I-RADIA REST OF WA
Washington Other 4102721 L&I-RADIA REST OF WA
Washington Other 0377759 L&I-RADIA REST OF WA
Washington MEDICAID 1054630 L&I-RADIA REST OF WA
Washington Other 4019715 L&I-RADIA REST OF WA

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