Provider Demographics
NPI:1407079841
Name:ONISHI, KATHRYN T (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:T
Last Name:ONISHI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KATHRYN
Other - Middle Name:KEIKO
Other - Last Name:TAKEDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:9800 HARBOUR PLACE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-4749
Mailing Address - Country:US
Mailing Address - Phone:425-493-8111
Mailing Address - Fax:425-493-1996
Practice Address - Street 1:9800 HARBOUR PLACE
Practice Address - Street 2:SUITE 203
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-4749
Practice Address - Country:US
Practice Address - Phone:425-493-8111
Practice Address - Fax:425-493-1996
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA000064931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice