Individual
MIKA MATSUMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
14655 BEL-RED ROAD, UNIT 101, BELLEVUE, WA 98007
(425) 641-4111
Mailing address
4547 8TH AVE NE APT 509, SEATTLE, WA 98105-6707
(808) 292-5396
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE61168232
WA
Other
Enumeration date
06/27/2021
Last updated
06/27/2021
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