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Individual

DR. JASON DAVID LATHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
15640 REDMOND WAY, REDMOND, WA 98052-3831
(425) 224-7592
Mailing address
5735 59TH AVE NE, SEATTLE, WA 98105-2027
(423) 322-6805

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE 60402432
WA

Other

Enumeration date
08/06/2013
Last updated
08/06/2013
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