Individual
DANIEL PERRY FOSMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1135 116TH AVE NE, SUITE 200, BELLEVUE, WA 98004-4623
(425) 709-7055
(425) 709-7066
Mailing address
PO BOX 94568, SEATTLE, WA 98124-6868
(888) 846-5527
(607) 324-2369
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
MD00037143
WA
2084N0400X
Neurology Physician
Primary
MD0037143
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0182685
L & I WORKERS COMP
WA
01
—
1223348 08
UNITED HEALTHCARE
WA
01
—
21171261225
UNIFORM MEDICAL PLAN
WA
01
—
4491936
AETNA
WA
01
—
5368FO
REGENCE BLUESHIELD
WA
01
—
770614555
TRIWEST
WA
05
—
8238685
—
WA
01
—
8930609
L & I CRIME VICTIMS
WA
Enumeration date
07/13/2006
Last updated
12/03/2010
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