Provider Demographics
NPI:1285887620
Name:KARL H. YAUCH, DDS, PS
Entity type:Organization
Organization Name:KARL H. YAUCH, DDS, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - PRES.
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:HERMAN
Authorized Official - Last Name:YOUCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-838-0661
Mailing Address - Street 1:2315 S.W. 320TH ST.
Mailing Address - Street 2:SUITE B
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-2514
Mailing Address - Country:US
Mailing Address - Phone:253-838-0661
Mailing Address - Fax:253-927-8378
Practice Address - Street 1:2315 S.W. 320TH STREET
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-2514
Practice Address - Country:US
Practice Address - Phone:253-838-0661
Practice Address - Fax:253-927-8378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3781122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5344908Medicaid