Healthcare Provider Details

I. General information

NPI: 1457218034
Provider Name (Legal Business Name): CARL W. YOUNGQUIST, D.D.S, P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 CALISTOGA ST W
ORTING WA
98360-2097
US

IV. Provider business mailing address

PO BOX 249
ORTING WA
98360-0249
US

V. Phone/Fax

Practice location:
  • Phone: 360-893-2122
  • Fax:
Mailing address:
  • Phone: 360-893-2122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CARL WESLEY YOUNGQUIST
Title or Position: PRESIDENT/DENTIST OWNER
Credential: DDS
Phone: 253-278-7522