Mickelson, Dayne Timothy

Mickelson, Dayne Timothy is an individual health care provider with primary practice located at 3101 Northup Way Ste 201 , Bellevue WA 98004-1435. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Mickelson, Dayne Timothy can be contacted via phone (425) 455-3600.

Contact Information

Primary practice address
3101 Northup Way Ste 201 Bellevue WA 98004-1435
Phone: (425) 455-3600
Fax: (425) 455-3920
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X MD60476167 Washington
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X MD60476167 Washington

Profile Details

NPI number 1982903142
LBN Legal business name Mickelson, Dayne Timothy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 26th, 2011
Last updated May 23rd, 2024 - about 7 months 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 1982903142 NPPES
Washington MEDICAID 2018712

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