Provider Demographics
NPI:1730533464
Name:DELUCCHI, DANIEL JOHN (DC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOHN
Last Name:DELUCCHI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 155TH ST SE
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-4857
Mailing Address - Country:US
Mailing Address - Phone:425-908-9545
Mailing Address - Fax:
Practice Address - Street 1:88 SPRING ST STE 123
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1099
Practice Address - Country:US
Practice Address - Phone:206-467-8611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60632389111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor