Provider Demographics
NPI:1437545514
Name:DANIELL, DOUGLAS MAGUIRE (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:MAGUIRE
Last Name:DANIELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11511 NE 10TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-8578
Mailing Address - Country:US
Mailing Address - Phone:425-502-3000
Mailing Address - Fax:844-620-1839
Practice Address - Street 1:11511 NE 10TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-8578
Practice Address - Country:US
Practice Address - Phone:425-502-3000
Practice Address - Fax:844-620-1839
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-15
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10092262-1205207P00000X
WAMD60879427207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT10092262-1205OtherUTAH MEDICAL LICENSE
UT10092262-8905OtherUTAH CONTROLLED SUBSTANCE LICENSE