Individual
DANIELLE BERGAN DEBELAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
WOODINVILLE TOWNE CENTER, 17638 140TH AVE NE, WOODINVILLE, WA 98072
(425) 485-4100
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00044058
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0203838
L&I
WA
05
—
1063598811
—
WA
01
—
2040302
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/27/2006
Last updated
08/27/2012
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