Individual
DAKITA MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
626 120TH AVE NE STE B201, BELLEVUE, WA 98005-3038
(425) 453-9060
Mailing address
6341 DESHONG DR, LITHONIA, GA 30058-6117
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5151013499
MI
Other
Enumeration date
06/04/2019
Last updated
06/26/2024
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