Provider Demographics
NPI:1083674253
Name:ISACKSON, DEANN W (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:DEANN
Middle Name:W
Last Name:ISACKSON
Suffix:
Gender:
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60297
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98160-0297
Mailing Address - Country:US
Mailing Address - Phone:425-417-8119
Mailing Address - Fax:
Practice Address - Street 1:10907 SE 66TH ST
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:WA
Practice Address - Zip Code:98056-1008
Practice Address - Country:US
Practice Address - Phone:360-435-6072
Practice Address - Fax:360-435-6172
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00033148207L00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology