Provider Demographics
NPI:1659527976
Name:TSUCHIKAWA, TREVOR KENJI (DDS)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:KENJI
Last Name:TSUCHIKAWA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 E WARD ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-4537
Mailing Address - Country:US
Mailing Address - Phone:206-852-6836
Mailing Address - Fax:
Practice Address - Street 1:302 WASHINGTON AVE S
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-5713
Practice Address - Country:US
Practice Address - Phone:206-852-6835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60035945122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist