Provider Demographics
NPI:1972660629
Name:NADELHOFFER, EVONNE
Entity Type:Individual
Prefix:DR
First Name:EVONNE
Middle Name:
Last Name:NADELHOFFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 N MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE SALMON
Mailing Address - State:WA
Mailing Address - Zip Code:98672-8751
Mailing Address - Country:US
Mailing Address - Phone:094-932-2445
Mailing Address - Fax:094-932-2425
Practice Address - Street 1:640 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:WHITE SALMON
Practice Address - State:WA
Practice Address - Zip Code:98672-8751
Practice Address - Country:US
Practice Address - Phone:509-493-2244
Practice Address - Fax:509-493-2242
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI57131223G0001X
WA600594591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice