# JAMAL KUSSAD LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dr. J. Alexander Kussad, DDS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467818500
- **Authorized official:** DR. JAMAL ALEXANDER KUSSAD D.D.S. (PRESIDENT)
- **Authorized official phone:** (360) 726-6107

## Contact information

- **Practice address:** 1901 NE 162ND AVE, SUITE D-112, VANCOUVER, WA 98684-3009
- **Practice address phone:** (360) 726-6107
- **Practice address fax:** (360) 726-6105
- **Mailing address:** 1901 NE 162ND AVE, SUITE D-112, VANCOUVER, WA 98684-3009
- **Mailing address phone:** (360) 726-6107
- **Mailing address fax:** (360) 726-6105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DE60457891 | WA | Yes |

## Other

- **Enumeration date:** 01/05/2016
- **Last updated:** 01/05/2016