Provider Demographics
NPI:1790005049
Name:ECKLAND, KALE (DDS)
Entity Type:Individual
Prefix:
First Name:KALE
Middle Name:
Last Name:ECKLAND
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 1:11605 132ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-8505
Mailing Address - Country:US
Mailing Address - Phone:425-739-8130
Mailing Address - Fax:425-739-8292
Practice Address - Street 1:11605 132ND AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-8505
Practice Address - Country:US
Practice Address - Phone:425-739-8130
Practice Address - Fax:425-739-8292
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 60145264122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist