Provider Demographics
NPI:1952619744
Name:PETE K NATHE DDS PC
Entity Type:Organization
Organization Name:PETE K NATHE DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:NATHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-965-7909
Mailing Address - Street 1:119 N 50TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-2862
Mailing Address - Country:US
Mailing Address - Phone:509-965-7909
Mailing Address - Fax:
Practice Address - Street 1:119 N 50TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-2862
Practice Address - Country:US
Practice Address - Phone:509-965-7909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 00005740122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6485310001Medicare NSC