Provider Demographics
NPI:1467727859
Name:VASHON FAMILY DENTISTRY
Entity Type:Organization
Organization Name:VASHON FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:CRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-463-9115
Mailing Address - Street 1:19001 VASHON HWY SW STE 100
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-5214
Mailing Address - Country:US
Mailing Address - Phone:206-463-9115
Mailing Address - Fax:
Practice Address - Street 1:19001 VASHON HWY SW STE 100
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070
Practice Address - Country:US
Practice Address - Phone:206-463-9115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA105991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty