Individual
TRIENEL M SACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
31775 STATE ROUTE 20, SUITE A-3, OAK HARBOR, WA 98277-5139
(360) 679-9216
(360) 679-9239
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(206) 764-0112
(206) 764-0489
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00008061
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0174962
DEPT LABOR & INDUSTRIES
WA
05
—
5028568
—
WA
01
—
8324SA
REGENCE BLUE SHIELD
WA
Enumeration date
11/21/2006
Last updated
07/09/2007
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