Provider Demographics
NPI:1124085659
Name:KASHIWA, PATTI CHIYO (DDS)
Entity type:Individual
Prefix:
First Name:PATTI
Middle Name:CHIYO
Last Name:KASHIWA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20615 BOTHELL EVERETT HWY
Mailing Address - Street 2:A
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012
Mailing Address - Country:US
Mailing Address - Phone:425-485-2942
Mailing Address - Fax:425-398-5933
Practice Address - Street 1:20615 BOTHELL EVERETT HWY
Practice Address - Street 2:A
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012
Practice Address - Country:US
Practice Address - Phone:425-485-2942
Practice Address - Fax:425-398-5933
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6096122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist