Provider Demographics
NPI:1225618333
Name:MCMANUS, DANIEL JOSEPH
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOSEPH
Last Name:MCMANUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 NW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-3533
Mailing Address - Country:US
Mailing Address - Phone:503-668-5210
Mailing Address - Fax:
Practice Address - Street 1:332 NW 1ST AVE
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013-3533
Practice Address - Country:US
Practice Address - Phone:503-668-5210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2024-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR220632213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist