Provider Demographics
NPI:1457567497
Name:KATHRYN T ONISHI DDS PS
Entity Type:Organization
Organization Name:KATHRYN T ONISHI DDS PS
Other - Org Name:HARBOUR PLACE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:T
Authorized Official - Last Name:ONISHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-493-8111
Mailing Address - Street 1:9800 HARBOUR PLACE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-4749
Mailing Address - Country:US
Mailing Address - Phone:425-493-8111
Mailing Address - Fax:425-493-1996
Practice Address - Street 1:9800 HARBOUR PLACE
Practice Address - Street 2:SUITE 203
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-4749
Practice Address - Country:US
Practice Address - Phone:425-493-8111
Practice Address - Fax:425-493-1996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAG064931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty