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Individual

MR. DANE SCOTT TRAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5343 TALLMAN AVE NW, SUITE 202, SEATTLE, WA 98107
(206) 547-0330
(206) 789-0140
Mailing address
5343 TALLMAN AVE NW, SUITE 202, SEATTLE, WA 98107
(206) 547-0330
(206) 789-0140

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00033916
WA
207Q00000X
Family Medicine Physician
MD9651
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1121086
WA
01
133038
L&I
Enumeration date
02/16/2006
Last updated
10/18/2010
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