Provider Demographics
NPI:1134688666
Name:NORTHWEST DENTAL SLEEP & WELLNESS CENTER
Entity Type:Organization
Organization Name:NORTHWEST DENTAL SLEEP & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KLAUDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-246-4635
Mailing Address - Street 1:2210 KULSHAN VIEW DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-2779
Mailing Address - Country:US
Mailing Address - Phone:360-424-0123
Mailing Address - Fax:
Practice Address - Street 1:2210 KULSHAN VIEW DR STE 101
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-2779
Practice Address - Country:US
Practice Address - Phone:360-424-0123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-14
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental