Provider Demographics
NPI:1275253825
Name:DANG, DAWSON JET DAI (DNP)
Entity Type:Individual
Prefix:
First Name:DAWSON
Middle Name:JET DAI
Last Name:DANG
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3375 OCEAN BEACH HWY
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-5902
Mailing Address - Country:US
Mailing Address - Phone:360-431-9781
Mailing Address - Fax:
Practice Address - Street 1:3375 OCEAN BEACH HWY
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-5902
Practice Address - Country:US
Practice Address - Phone:360-431-9781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program