Basic Information
Provider Information
NPI: 1770243099
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DANIEL
FirstName: BRIANA
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: RN, BSN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7440 W MARGINAL WAY S
Address2:  
City: SEATTLE
State: WA
PostalCode: 981084141
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1302 W GARDNER AVE
Address2:  
City: SPOKANE
State: WA
PostalCode: 992012059
CountryCode: US
TelephoneNumber: 5095036010
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/28/2021
LastUpdateDate: 12/28/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/28/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN60988360WAY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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