Provider Demographics
NPI:1356138747
Name:DAGNAW, YINAGER AGEDIE (MD)
Entity type:Individual
Prefix:DR
First Name:YINAGER
Middle Name:AGEDIE
Last Name:DAGNAW
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12460 28TH AVE S APT 3
Mailing Address - Street 2:12460 28TH AVE S APT 3
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98168
Mailing Address - Country:US
Mailing Address - Phone:206-407-6109
Mailing Address - Fax:
Practice Address - Street 1:917 PACIFIC AVE STE 600
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-4437
Practice Address - Country:US
Practice Address - Phone:253-232-7495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMDCE.ML.61687149208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice