Provider Demographics
NPI:1548520521
Name:NELSON, DANIELLE MARIE (MS)
Entity type:Individual
Prefix:MISS
First Name:DANIELLE
Middle Name:MARIE
Last Name:NELSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22609 SE 270TH PL
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-6815
Mailing Address - Country:US
Mailing Address - Phone:425-221-2248
Mailing Address - Fax:
Practice Address - Street 1:710 SOUTH EAST 70TH STREET
Practice Address - Street 2:SUITE 108
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027
Practice Address - Country:US
Practice Address - Phone:425-392-4965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist