Individual
FAWAZ HATEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BDS, MSD
Contact information
Practice address
11540 15TH AVE NE, SEATTLE, WA 98125-6322
(206) 440-1500
Mailing address
3608 231ST PL SE, BOTHELL, WA 98021-6214
(509) 539-6475
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE.61153474
WA
125Q00000X
Oral Medicine Dentistry
DENT.DE.61153474
WA
Other
Enumeration date
10/05/2021
Last updated
08/05/2025
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