Healthcare Provider Details

I. General information

NPI: 1811541683
Provider Name (Legal Business Name): BIRKIN OWART DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2019
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4741 THRALL RD
ELLENSBURG WA
98926-8440
US

IV. Provider business mailing address

4741 THRALL RD
ELLENSBURG WA
98926-8440
US

V. Phone/Fax

Practice location:
  • Phone: 509-899-5110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE60957416
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: