Provider Demographics
NPI:1982946919
Name:NOZOMI YAMATE DMD, PLLC
Entity Type:Organization
Organization Name:NOZOMI YAMATE DMD, PLLC
Other - Org Name:VALUE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NOZOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:YAMATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-256-1333
Mailing Address - Street 1:6115 NE 114TH AVE STE 113
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6350
Mailing Address - Country:US
Mailing Address - Phone:360-256-1333
Mailing Address - Fax:
Practice Address - Street 1:6115 NE 114TH AVE STE 113
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6350
Practice Address - Country:US
Practice Address - Phone:360-256-1333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60032064122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty