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Individual

DANIEL MARK GREENWALD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA, ARNP

Contact information

Practice address
111 S 13TH ST, MOUNT VERNON, WA 98274-4105
(360) 336-2178
Mailing address
PO BOX 2329, MOUNT VERNON, WA 98273-7329
(360) 336-6517
(360) 757-3870

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30000594
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0124116
DEPARTMENT OF LABOR AND INDUSTRIES
WA
01
2533GR
REGENCE BLUE SHIELD
WA
01
500008683
RAILROAD MEDICARE
WA
05
9622317
WA
Enumeration date
10/15/2005
Last updated
07/14/2008
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