Provider Demographics
NPI:1558138800
Name:HADI YOUSSEF DMD PLLC.
Entity Type:Organization
Organization Name:HADI YOUSSEF DMD PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:HADI
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSSEF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-841-9113
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty