Individual provider Active NPI

Daniel Aaron Kodner, MD

  • Psychiatry Physician
  • Seattle, WA
National Provider Identifier
1336159938
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD00036116 Issued in WA
Practice address
6707 35TH PL S
Seattle, WA 98118-6454
Phone
(206) 552-0312
Fax
(206) 338-9960
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X C52500 CA
Psychiatry Physician 2084P0800X 11802 NV
Psychiatry Physician 2084P0800X MD00036116 WA Primary

Addresses

Primary practice location

6707 35TH PL S
Seattle, WA 98118-6454

Mailing address

4742 42ND Ave SW # 412
Seattle, WA 98116-4553
Phone (206) 552-0312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 31, 2022 through Jan 31, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C52500CAMDPsychiatry Physician
11802NVMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1336159938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4742 42ND AVE SW # 412",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164553",
            "telephone_number": "206-552-0312",
            "fax_number": "206-338-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6707 35TH PL S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981186454",
            "telephone_number": "206-552-0312",
            "fax_number": "206-338-9960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODNER",
        "first_name": "DANIEL",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C52500",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "11802",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD00036116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.