Individual
TARJA KAAKKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 NW GILMAN BLVD, SUITE E-103, #493, ISSAQUAH, WA 98027-5395
(206) 355-1596
(425) 369-9785
Mailing address
700 NW GILMAN BLVD, SUITE E-103, #493, ISSAQUAH, WA 98027-5395
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
9397
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5040324
—
WA
05
—
5056239
—
WA
Enumeration date
11/22/2006
Last updated
07/11/2008
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