Individual
DR. JOEL N FAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
20673 SW ROY ROGERS RD, STE. 201, SHERWOOD, OR 97140-9222
(503) 925-0588
(503) 925-0418
Mailing address
20673 SW ROY ROGERS RD, STE. 201, SHERWOOD, OR 97140-9222
(503) 925-0588
(503) 925-0418
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00010671
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0214008
LABOR & INDUSTRIES ID #
WA
05
—
5051677
—
WA
Enumeration date
02/14/2007
Last updated
06/07/2010
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