Provider Demographics
NPI:1366472607
Name:KASHNER, JEFFREY EARL (DDS,MSD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:EARL
Last Name:KASHNER
Suffix:
Gender:M
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 BELLEVUE AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-6928
Mailing Address - Country:US
Mailing Address - Phone:253-630-3331
Mailing Address - Fax:253-630-6881
Practice Address - Street 1:17121 SE 270TH PL
Practice Address - Street 2:SUITE 102
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-5431
Practice Address - Country:US
Practice Address - Phone:253-630-3331
Practice Address - Fax:253-630-6881
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000080211223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA91111635526OtherKITSAP PHYSICIAN SERVICE