Provider Demographics
NPI:1083831085
Name:DARRIN A RAPOPORT
Entity Type:Organization
Organization Name:DARRIN A RAPOPORT
Other - Org Name:PACIFIC NORTHWEST PERIODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:LEAH
Authorized Official - Last Name:SINCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-575-1086
Mailing Address - Street 1:411 STRANDER BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2935
Mailing Address - Country:US
Mailing Address - Phone:206-575-1086
Mailing Address - Fax:206-575-0829
Practice Address - Street 1:411 STRANDER BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2935
Practice Address - Country:US
Practice Address - Phone:206-575-1086
Practice Address - Fax:206-575-0829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE85081223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty