Provider Demographics
NPI:1245595669
Name:HATTAWAY, PEANUT WAI-PING WONG (DMD)
Entity type:Individual
Prefix:DR
First Name:PEANUT
Middle Name:WAI-PING WONG
Last Name:HATTAWAY
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 POWELL AVE SW
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2908
Mailing Address - Country:US
Mailing Address - Phone:425-277-1311
Mailing Address - Fax:425-277-1566
Practice Address - Street 1:16255 NE 87TH ST STE 150
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7464
Practice Address - Country:US
Practice Address - Phone:425-883-8000
Practice Address - Fax:425-883-7580
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602844171223G0001X
WADE60284417122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice