Provider Demographics
NPI:1700919990
Name:EMBREE, KATRINA GAIL (DENTAL ASSISTANT)
Entity Type:Individual
Prefix:MISS
First Name:KATRINA
Middle Name:GAIL
Last Name:EMBREE
Suffix:
Gender:F
Credentials:DENTAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17401 SE 28TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-3427
Mailing Address - Country:US
Mailing Address - Phone:360-448-1680
Mailing Address - Fax:
Practice Address - Street 1:17401 SE 28TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-3427
Practice Address - Country:US
Practice Address - Phone:360-448-1680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant