Dane Scott Travis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00033916 Issued in WA

Practice address

5343 Tallman Ave NW
Suite 202
Seattle, WA 98107

Phone

(206) 547-0330

Fax

(206) 789-0140

NPI assigned

Feb 16, 2006

Last updated

Oct 18, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1487628202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5343 TALLMAN AVE NW",
            "address_2": "SUITE 202",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98107",
            "telephone_number": "206-547-0330",
            "fax_number": "206-789-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5343 TALLMAN AVE NW",
            "address_2": "SUITE 202",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98107",
            "telephone_number": "206-547-0330",
            "fax_number": "206-789-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "DANE",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00033916",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD9651",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1121086",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "133038",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chandra Travers, LMP
• Tiffany Louise Travers
• Elsa Traverso
• Patricia Travi, RN
• Daniela Isabel Travieso, LMT
• Kristin Jeanine Travis
• Roosevelt Travis Jr., L.C.S.W.
• Savannah Travis
• Mary Patricia Traxler, PH.D.
• Thomas J Treacy

• Family Medicine Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.