Provider Demographics
NPI:1487631248
Name:KATHY A CURTIS DDS, PLLC
Entity Type:Organization
Organization Name:KATHY A CURTIS DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-624-9912
Mailing Address - Street 1:925 4TH AVE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1157
Mailing Address - Country:US
Mailing Address - Phone:206-624-9912
Mailing Address - Fax:206-624-2520
Practice Address - Street 1:925 4TH AVE
Practice Address - Street 2:STE 410
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1157
Practice Address - Country:US
Practice Address - Phone:206-624-9912
Practice Address - Fax:206-624-2520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000065171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6517WAOtherDELTA DENTAL
WA4590CUOtherREGENCE BLUE SHIELD
WA4590CUOtherREGENCE BLUE SHIELD