| Full Name | |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 1119 4th Ave, Seattle, Washington |
| Authorized Official Name and Position | Tara Lawson Kois (OWNER/DENTIST) |
| Authorized Official Contact | 2069094597 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1001 Fairview Ave. N. Suite 2200 Seattle WA 98109 Ph: (206) 515-9500 | 1119 4th Ave Seattle WA 98101 Ph: (206) 623-4400 |
| NPI Number | 1992185052 |
|---|---|
| Provider Enumeration Date | 06/04/2015 |
| Last Update Date | 06/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992185052 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | 10393 (Washington) | Primary |
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