Individual
DANIEL E SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
30809 1ST AVE S, FEDERAL WAY, WA 98003-4074
(253) 839-2030
Mailing address
30809 1ST AVE S, FEDERAL WAY, WA 98003-4074
(253) 839-2030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP00000916
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0199174
L & I
WA
01
—
0290136
L&I
WA
01
—
0290137
L&I
WA
05
—
1819309
—
WA
01
—
8906585
CRIME VICTIMS
WA
01
—
G8906803
MEDICARE
WA
01
—
P00338282
RAILROAD
WA
Enumeration date
07/07/2006
Last updated
03/23/2012
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