Organization
DERICK W. HAHN D.D.S., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERICK WAYNE HAHN D.D.S. (DENTIST)
(206) 778-0592
Entity
Organization
Contact information
Practice address
1107 SW GRADY WAY, SUITE 200, RENTON, WA 98057-5217
(425) 226-9270
(425) 254-1129
Mailing address
720 S 38TH CT, RENTON, WA 98055-5894
(206) 778-0592
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60035932
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699929167
TYPE 1 NPI NUMBER
WA
Enumeration date
05/14/2013
Last updated
05/14/2013
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