# MARIANNA BEETHAM, D.D.S., P.S.

> 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
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982739108
- **Authorized official:** INNA RAND (OFFICE STAFF)
- **Authorized official phone:** (425) 825-8800

## Contact information

- **Practice address:** 12911 120TH AVE NE, STE B-60, KIRKLAND, WA 98034
- **Practice address phone:** (425) 825-8800
- **Practice address fax:** (425) 825-8808
- **Mailing address:** 12911 120TH AVE NE, STE B-60, KIRKLAND, WA 98034
- **Mailing address phone:** (425) 825-8800
- **Mailing address fax:** (425) 825-8808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 9356 | WA | Yes |

## Other

- **Enumeration date:** 02/21/2007
- **Last updated:** 04/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1665021 | UNITED CONCORDIA | — |
| 01 | — | 2957KH | BLUECROSSBLUESHIELD | — |