Provider Demographics
NPI:1659313013
Name:PRIEBE, EMILY DONNA (RDH)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:DONNA
Last Name:PRIEBE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 8TH AVE NE
Mailing Address - Street 2:#201
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-6924
Mailing Address - Country:US
Mailing Address - Phone:206-633-6312
Mailing Address - Fax:
Practice Address - Street 1:1534 BROADWAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-3811
Practice Address - Country:US
Practice Address - Phone:206-323-7727
Practice Address - Fax:206-323-0733
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHL00007461124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist