Provider Demographics
NPI:1740390749
Name:YAREMKO, ERIC ALAN (DMD PS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ALAN
Last Name:YAREMKO
Suffix:
Gender:M
Credentials:DMD PS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 LAKEWAY DR
Mailing Address - Street 2:STE A
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225
Mailing Address - Country:US
Mailing Address - Phone:360-734-6620
Mailing Address - Fax:360-676-1664
Practice Address - Street 1:520 LAKEWAY DR
Practice Address - Street 2:STE A
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-734-6620
Practice Address - Fax:360-676-1664
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA561821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
873030OtherUNITED CONCORDIA