NPI 1972919496

Willamette Dental Group

Organisation Exclusive Provider Organization Yakima, WA

Practice location

Address: 1200 Chesterly Dr, Yakima, WA 98902-7338
Phone: (509) 452-7825
Mailing address: 6950 NE Campus Way, Hillsboro, OR 97124-5611

Authorised official

Name: Eugene Skourtes
Title: Owner/Ceo
Phone: (855) 433-6825

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence H6653 (OR)

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Registry record

NPI: 1972919496
Entity type: Organization
NPI issued: 3 Jul 2014
Record last updated: 3 Jul 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.