Slack, Daniel Forrest

Slack, Daniel Forrest is an individual health care provider with primary practice located at 939 Caroline St , Port Angeles WA 98362-3909. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Slack, Daniel Forrest can be contacted via phone (360) 417-7711.

Contact Information

Primary practice address
939 Caroline St Port Angeles WA 98362-3909
Phone: (360) 417-7711
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 6134-33 Washington
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 201606815CRNA-P Oregon
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 64001 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 712720 New York
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X AP60651342 Washington

Profile Details

NPI number 1780098442
LBN Legal business name Slack, Daniel Forrest
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2014
Last updated Jul 14th, 2022 - about 2 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 1780098442 NPPES
Washington MEDICAID 2093758

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