Provider Demographics
NPI:1750790515
Name:SAITO, TRACI (DMD, MS, MHA)
Entity type:Individual
Prefix:DR
First Name:TRACI
Middle Name:
Last Name:SAITO
Suffix:
Gender:F
Credentials:DMD, MS, MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SE 120TH AVE STE 900
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-4094
Mailing Address - Country:US
Mailing Address - Phone:360-256-7220
Mailing Address - Fax:360-253-2907
Practice Address - Street 1:1677 MOLALLA AVE
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-4007
Practice Address - Country:US
Practice Address - Phone:503-433-3641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-06
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD10077122300000X, 1223X0400X
AZD009350122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist