Daniel V. Phan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD32737 Issued in WA

Practice address

6508 196TH St SW
Lynnwood, WA 98036-5922

Phone

(425) 673-2572

Fax

(425) 673-4131

NPI assigned

Sep 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1871589135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6508 196TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365922",
            "telephone_number": "425-673-2572",
            "fax_number": "425-673-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6508 196TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365922",
            "telephone_number": "425-673-2572",
            "fax_number": "425-673-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "DANIEL",
        "middle_name": "V.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD32737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRY",
            "identifier": "118997",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD",
            "identifier": "PH7245",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1103761",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John R Pfeifer, O.D.
• Mark J. Pfleger, M.D.
• Jennifer T. Pha M, O.D.
• Pham, Anwar PLLC
• Thuy-Ha Pham, RPH
• Phillips Rehab and Performance
• Benjamin Pierce
• Christine Pierce, RN
• Michael Piercy
• Catherine Ann Pike, ARNP, RNFA

• Internal Medicine Physician in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.