Individual
ASHLEY ANN TADEHARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
803 S MAIN ST STE 120, MOSCOW, ID 83843-2695
(208) 848-8300
Mailing address
203 N WASHINGTON ST STE 300, SPOKANE, WA 99201-0254
(509) 444-8888
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH-3580
ID
124Q00000X
Dental Hygienist
DH61011478
WA
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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