Provider Demographics
NPI:1780755017
Name:DANOFF, NANCY LYNN (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LYNN
Last Name:DANOFF
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6808 30TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-7241
Mailing Address - Country:US
Mailing Address - Phone:206-525-6608
Mailing Address - Fax:
Practice Address - Street 1:14350 SE EASTGATE WAY
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-6458
Practice Address - Country:US
Practice Address - Phone:206-296-9754
Practice Address - Fax:206-296-0557
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00025628208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8116774Medicaid
WABD0520278OtherDEA
WA8116774Medicaid