1396976239 NPI number — AARIKA DAWN ANDERSON ELTER DMD

Table of content: AARIKA DAWN ANDERSON ELTER DMD (NPI 1396976239)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396976239 NPI number — AARIKA DAWN ANDERSON ELTER DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANDERSON ELTER
Provider First Name:
AARIKA
Provider Middle Name:
DAWN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ANDERSON
Provider Other First Name:
AARIKA
Provider Other Middle Name:
DAWN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DMD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396976239
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 12TH AVE S
Provider Second Line Business Mailing Address:
SUITE 901
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98144-2712
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-548-3114
Provider Business Mailing Address Fax Number:
206-762-6355

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2215 N 30TH ST STE 301
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98403-3350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-238-1402
Provider Business Practice Location Address Fax Number:
253-238-1403
Provider Enumeration Date:
07/27/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223P0221X , with the licence number:  DE60101692 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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