Provider Demographics
NPI:1154999670
Name:PREW, KARA LINDSAY (RDH)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:LINDSAY
Last Name:PREW
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6424 MADRONA DR NE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98422-1217
Mailing Address - Country:US
Mailing Address - Phone:425-372-8833
Mailing Address - Fax:
Practice Address - Street 1:6424 MADRONA DR NE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98422-1217
Practice Address - Country:US
Practice Address - Phone:425-372-8833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH00007382124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty