Individual
MARK DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PCNP
Contact information
Practice address
340 9TH ST, FLORENCE, OR 97439
(541) 902-1634
(541) 902-9702
Mailing address
1115 SE 164TH AVE DEPT 358, VANCOUVER, WA 98683-8004
(360) 729-1412
(360) 729-3025
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
201402362RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201810942NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
53268
NM
Other
Enumeration date
08/06/2014
Last updated
05/28/2019
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