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Daniel Matthew Dhulst

Anesthesiology

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as DANIEL DHULST.

Based on the most recent information from CMS, provider Daniel Matthew Dhulst is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1407861362
Provider Type
Individual
Full Name
Dhulst, Daniel Matthew
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
7/29/2006
Last Updated
11/25/2016

Contact Information

Practice Location

101 W 8th Ave, Spokane, WA 99204-2307

(509) 474-3131

Unlisted Fax

Mailing Location

PO Box 94645, Seattle, WA 98124-6945

(509) 474-3131

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207L00000X Primary	Description Anesthesiology Allopathic & Osteopathic Physicians	License 43420 Washington

Provider Identifiers

ID	Description	Issuer
ID 8390916	Description Medicaid	Issuer Unlisted Washington

Daniel Matthew Dhulst

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Croschere, Thomas

Inahara, Gerald

Scott, Paul Michael

Ferries, Michael C

Leclair, Bronson Matthias

Burgan, Jeffrey

Spencer, Chad

Tully, Brian William

Miller, Andrew

Cornish-Vermaire, Deborah J