Individual
DR. DAN ALGOT WIKLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
929 E MAIN AVE, SUITE 210, PUYALLUP, WA 98372-3116
(253) 848-9563
(253) 840-5519
Mailing address
929 E MAIN AVE, SUITE 210, PUYALLUP, WA 98372-3116
(253) 848-9563
(253) 840-5519
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
MD00018183
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1050863
—
WA
01
—
53030
GROUP: DEPT L&I
WA
01
—
53031
DEPT OF LABOR AND IND
WA
05
—
7095656
—
WA
Enumeration date
08/03/2005
Last updated
01/26/2010
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