Provider Demographics
NPI:1205016920
Name:YAMAMOTO, DOROTHY T (RDH)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:T
Last Name:YAMAMOTO
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:605 W 1ST
Mailing Address - City:WARDEN
Mailing Address - State:WA
Mailing Address - Zip Code:98857
Mailing Address - Country:US
Mailing Address - Phone:509-349-7420
Mailing Address - Fax:509-349-2357
Practice Address - Street 1:605 W 1ST
Practice Address - Street 2:
Practice Address - City:WARDEN
Practice Address - State:WA
Practice Address - Zip Code:98857
Practice Address - Country:US
Practice Address - Phone:509-349-7420
Practice Address - Fax:509-349-2357
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1509124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist