Individual
DR. TY WILLIAM ETHERIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
3130 E MADISON ST, SUITE 103, SEATTLE, WA 98112-4264
(206) 323-0990
(206) 323-0977
Mailing address
3130 E MADISON ST, SUITE 103, SEATTLE, WA 98112-4264
(206) 323-0990
(206) 323-0977
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00008770
WA
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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