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Organization
NW AFFINITY DENTAL
Active
Organization
NW AFFINITY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEREK MICHAUD (DENTIST)
(360) 253-3500
Entity
Organization
Contact information
Practice address
19120 SE 34TH ST, SUITE 104, VANCOUVER, WA 98683-1429
(360) 253-3500
(360) 823-0267
Mailing address
19120 SE 34TH ST, SUITE 104, VANCOUVER, WA 98683-1429
(360) 253-3500
(360) 823-0267
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE00011060
WA
Other
Enumeration date
08/02/2016
Last updated
08/02/2016
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