Provider Demographics
NPI:1548566433
Name:TREVOR TSUCHIKAWA DDS II PLLC
Entity Type:Organization
Organization Name:TREVOR TSUCHIKAWA DDS II PLLC
Other - Org Name:CARNATION FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:
Authorized Official - Last Name:TSUCHIKAWA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-333-4101
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:CARNATION
Mailing Address - State:WA
Mailing Address - Zip Code:98014-0909
Mailing Address - Country:US
Mailing Address - Phone:425-333-4101
Mailing Address - Fax:
Practice Address - Street 1:4466 TOLT AVE
Practice Address - Street 2:
Practice Address - City:CARNATION
Practice Address - State:WA
Practice Address - Zip Code:98014
Practice Address - Country:US
Practice Address - Phone:425-333-4101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60035945122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty