Provider Demographics
NPI:1518569235
Name:YOUSSEF, HADI (DMD)
Entity Type:Individual
Prefix:DR
First Name:HADI
Middle Name:
Last Name:YOUSSEF
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16913 NE 30TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-7313
Mailing Address - Country:US
Mailing Address - Phone:503-841-9113
Mailing Address - Fax:
Practice Address - Street 1:640 GOERIG ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:WA
Practice Address - Zip Code:98674-9401
Practice Address - Country:US
Practice Address - Phone:971-231-5124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA612139461223G0001X
CA1057541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty