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22619 Se 64th Pl Suite 110 Issaquah WA 98027-5342 | |
| (425) 392-7000 | |
| (425) 392-7001 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 22619 Se 64th Pl, Issaquah, Washington |
| Authorized Official Name and Position | Kari C Woo (OWNER) |
| Authorized Official Contact | 2068170723 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
22619 Se 64th Pl Suite 110 Issaquah WA 98027-5342 Ph: (425) 392-7000 | 22619 Se 64th Pl Suite 110 Issaquah WA 98027-5342 Ph: (425) 392-7000 |
| NPI Number | 1750625604 |
|---|---|
| Provider Enumeration Date | 11/15/2012 |
| Last Update Date | 11/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750625604 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DE60059356 (Washington) | Primary |
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