# PACKARD, PACKARD & PACKARD, PS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Creekside Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811085665
- **Authorized official:** LESLEE R THYSELL (OFFICE MANAGER)
- **Authorized official phone:** (509) 577-8277

## Contact information

- **Practice address:** 1501 S 40TH AVE, YAKIMA, WA 98908-3963
- **Practice address phone:** (509) 577-8277
- **Practice address fax:** (509) 573-4858
- **Mailing address:** 1501 S 40TH AVE, YAKIMA, WA 98908-3963
- **Mailing address phone:** (509) 577-8277
- **Mailing address fax:** (509) 573-4858

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 601472726 | WA | Yes |

## Other

- **Enumeration date:** 10/10/2006
- **Last updated:** 03/29/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5020037 | — | WA |