Provider Demographics
NPI:1255487443
Name:KARTJE, KARYN (DMD)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:
Last Name:KARTJE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:KARYN
Other - Middle Name:
Other - Last Name:TINDAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:14600 SE VALENCIA DR
Mailing Address - Street 2:212
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-5435
Mailing Address - Country:US
Mailing Address - Phone:503-939-1402
Mailing Address - Fax:
Practice Address - Street 1:1201 SE TECH CENTER DR
Practice Address - Street 2:150
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-5512
Practice Address - Country:US
Practice Address - Phone:360-892-7107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-28
Last Update Date:2014-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00010801122300000X
ORD8864122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist