Healthcare Provider Details

I. General information

NPI: 1861311342
Provider Name (Legal Business Name): EMILY SIERRA GREATHOUSE RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6060 PORTAL WAY
FERNDALE WA
98248-9360
US

IV. Provider business mailing address

740 N PARK ST
LYNDEN WA
98264-8586
US

V. Phone/Fax

Practice location:
  • Phone: 360-676-6177
  • Fax: 360-671-3574
Mailing address:
  • Phone: 360-483-8343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDEHY.DH.70146018
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: