Daniel Leahy Graves, MD

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

17917 Issued in WA

Practice address

17900 Talbot Rd S
#101
Renton, WA 98055-8212

Phone

(425) 235-9614

Fax

(425) 235-1060

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Maranatha Medical Clinic Inc P S

  • Clinic/Center
  • Renton, WA
  • NPI 1063748861
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1255365839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17900 TALBOT RD S,",
            "address_2": "#101",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980558242",
            "telephone_number": "425-235-9614",
            "fax_number": "425-235-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17900 TALBOT RD S",
            "address_2": "#101",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980558212",
            "telephone_number": "425-235-9614",
            "fax_number": "425-235-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "DANIEL",
        "middle_name": "LEAHY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "WA",
            "license": "17917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1620509",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn Renee Granata, CO
• Bradford Deahl Granath, M.D.
• Grandcare Limited Liability Company
• Laurel Granger, M.A., L.M.H.C
• Traci Suzanne Granston, MD
• Claudia Payne Gravett, M.S.
• Jesse Marie Gray, PA-C
• Fabione Green
• Jerry Eugene Green, M.A.
• Kimberly Green, M.A.

• Legal Medicine in Renton, WA
• Providers in Renton, WA by specialty
• Legal Medicine in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.