Individual
DR. SHANNON S FARAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
10217 125TH STREET CT E, PUYALLUP, WA 98374-2761
(253) 864-4760
(253) 864-4766
Mailing address
10217 125TH STREET CT E, PUYALLUP, WA 98374-2761
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE 60391320
WA
Other
Enumeration date
09/18/2013
Last updated
04/19/2017
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