Individual
DR. ERIC D. DANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
850 MAPLE STREET, EASTERN STATE HOSPITAL, MEDICAL LAKE, WA 99022-0800
(509) 565-4000
(509) 565-4705
Mailing address
PO BOX 800, EASTERN STATE HOSPITAL, MEDICAL LAKE, WA 99022-0800
(509) 565-4000
(509) 565-4705
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
M8280
ID
207Q00000X
Family Medicine Physician
Primary
MD00030830
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
806187300
BOUNDARY COMMUNITY HOSP
ID
05
—
806187300
—
ID
01
—
8147910
MEDICAID
WA
05
—
8147910
—
WA
Enumeration date
01/30/2006
Last updated
10/20/2016
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