Individual
KRISTIN NORDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1057 12TH AVE, LONGVIEW, WA 98632-2509
(360) 636-3892
(360) 414-1114
Mailing address
1057 12TH AVE, LONGVIEW, WA 98632-2509
(360) 636-3892
(360) 414-1114
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60035277
WA
163W00000X
Registered Nurse
RN00131874
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5059464
—
WA
Enumeration date
02/13/2009
Last updated
09/13/2023
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