Individual
NIDIA MARCELA FORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH, OMT
Contact information
Practice address
500 SE EVERETT MALL WAY STE B222, EVERETT, WA 98208-8128
(425) 205-5956
Mailing address
500 SE EVERETT MALL WAY STE B222, EVERETT, WA 98208-8128
(425) 205-5956
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DEHL.HL.60287128
WA
Other
Enumeration date
03/11/2026
Last updated
03/11/2026
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