Organization
SEQUIM FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI JOHNSON (PRACTICE ADMINISTRATOR)
(360) 681-8884
Entity
Organization
Contact information
Practice address
321 N SEQUIM AVE # B, SEQUIM, WA 98382-3457
(360) 681-8884
Mailing address
PO BOX 3430, SEQUIM, WA 98382-5028
(360) 681-8884
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10482
WA
122300000X
Dentist
Primary
5445
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144212804
INDIVIDUAL NPI
WA
01
—
1952398661
INDIVIDUAL NPI
WA
Enumeration date
08/11/2016
Last updated
08/11/2016
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