# NATE REPTA DMD PS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265088041
- **Authorized official:** NATE REPTA DMD (SHAREHOLDER)
- **Authorized official phone:** (503) 453-3641

## Contact information

- **Practice address:** 275 PENDLETON WAY, WASHOUGAL, WA 98671-4203
- **Practice address phone:** (503) 453-3641
- **Mailing address:** 693 32ND ST UNIT 5, WASHOUGAL, WA 98671-1865

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 08/16/2019
- **Last updated:** 08/16/2019