Provider Demographics
NPI:1275275786
Name:MICHITSUNA KATAFUCHI, PLLC
Entity Type:Organization
Organization Name:MICHITSUNA KATAFUCHI, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHITSUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KATAFUCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-849-2970
Mailing Address - Street 1:1270 140TH PL NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-4049
Mailing Address - Country:US
Mailing Address - Phone:206-849-2970
Mailing Address - Fax:
Practice Address - Street 1:12911 120TH AVE NE STE F240
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3054
Practice Address - Country:US
Practice Address - Phone:206-849-2970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-13
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty