Healthcare Provider Details

I. General information

NPI: 1275529034
Provider Name (Legal Business Name): DONALD J ARIMA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 S BIRCH ST
MCCLEARY WA
98557-9522
US

IV. Provider business mailing address

330 S BIRCH ST
MCCLEARY WA
98557-9522
US

V. Phone/Fax

Practice location:
  • Phone: 360-495-3666
  • Fax: 360-495-4324
Mailing address:
  • Phone: 360-495-3666
  • Fax: 360-495-4324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5538
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: