Provider Demographics
NPI:1871975615
Name:SPYKER, DANIEL ADRIAN (PHD, MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ADRIAN
Last Name:SPYKER
Suffix:
Gender:M
Credentials:PHD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29903 NE 64TH CIR
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-8813
Mailing Address - Country:US
Mailing Address - Phone:360-210-5102
Mailing Address - Fax:
Practice Address - Street 1:29903 NE 64TH CIR
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-8813
Practice Address - Country:US
Practice Address - Phone:360-210-5102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-28
Last Update Date:2015-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG87351207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine