Provider Demographics
NPI:1467764563
Name:YAMAGUCHI, STEFANIE K HAMAMOTO (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEFANIE
Middle Name:K HAMAMOTO
Last Name:YAMAGUCHI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8511 GREENWOOD AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-3613
Mailing Address - Country:US
Mailing Address - Phone:206-782-8223
Mailing Address - Fax:
Practice Address - Street 1:22703 BOTHELL EVERETT HWY STE E
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-8494
Practice Address - Country:US
Practice Address - Phone:425-488-1480
Practice Address - Fax:425-489-9997
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60172421122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist