Provider Demographics
NPI:1710465158
Name:HINOJOSA, GINA
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:HINOJOSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:CONTRATTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24223 229TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-5162
Mailing Address - Country:US
Mailing Address - Phone:425-829-3589
Mailing Address - Fax:
Practice Address - Street 1:1507 S 348TH ST STE K2-102
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8374
Practice Address - Country:US
Practice Address - Phone:253-835-3377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-28
Last Update Date:2018-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH00007675124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist