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Individual

MR. WAYNE DALY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6405 218TH ST SW, SUITE 301, MOUNTLAKE TERRACE, WA 98043-2180
(425) 771-0797
(206) 219-1144
Mailing address
6405 218TH ST SW, SUITE 301, MOUNTLAKE TERRACE, WA 98043-2180
(425) 771-0797
(206) 219-1144

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
OI00000010
WA
224P00000X
Prosthetist
Primary
PS00000011
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9015561
WA
Enumeration date
07/26/2007
Last updated
10/22/2012
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