Provider Demographics
NPI:1215053988
Name:DESKINS, EILEEN KUO (DDS)
Entity type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:KUO
Last Name:DESKINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:
Other - Last Name:KUO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:9600 VETERAN'S DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98493
Mailing Address - Country:US
Mailing Address - Phone:253-983-8058
Mailing Address - Fax:
Practice Address - Street 1:716 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-2847
Practice Address - Country:US
Practice Address - Phone:360-736-0795
Practice Address - Fax:360-330-1637
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA104911223G0001X
WADE000104911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice