Basic Information
Provider Information
NPI: 1255474912
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BALDINI
FirstName: DANIEL
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 34584
Address2:  
City: SEATTLE
State: WA
PostalCode: 981241584
CountryCode: US
TelephoneNumber: 5092417349
FaxNumber: 5092417628
Practice Location
Address1: 2700 152ND AVE NE
Address2:  
City: REDMOND
State: WA
PostalCode: 980525543
CountryCode: US
TelephoneNumber: 4258835151
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/14/2007
LastUpdateDate: 08/25/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XMD00018193WAY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
843700605WA MEDICAID
843700601WAVMMC DSHS NUMBEROTHER
G887345901WAVMMC MEDICARE NUMBEROTHER


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