Provider Demographics
NPI:1609873108
Name:VAN DER HOEVEN, EVA C (DDS)
Entity Type:Individual
Prefix:DR
First Name:EVA
Middle Name:C
Last Name:VAN DER HOEVEN
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 1:22619 SE 64TH PL
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-5342
Mailing Address - Country:US
Mailing Address - Phone:425-392-4888
Mailing Address - Fax:425-392-8321
Practice Address - Street 1:22619 SE 64TH PL
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5342
Practice Address - Country:US
Practice Address - Phone:425-392-4888
Practice Address - Fax:425-392-8321
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0348OtherDELTA DENTAL
WA526943OtherUNITED CONCORDIA
WA0348OtherDELTA DENTAL