Healthcare Provider Details

I. General information

NPI: 1962587477
Provider Name (Legal Business Name): ALISON H HAN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HAI-TIEN HAN DMD

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 03/08/2024
Certification Date: 03/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16300 REDMOND WAY STE 200
REDMOND WA
98052-3856
US

IV. Provider business mailing address

16300 REDMOND WAY STE 201
REDMOND WA
98052-3856
US

V. Phone/Fax

Practice location:
  • Phone: 425-885-0200
  • Fax: 425-885-7601
Mailing address:
  • Phone: 425-885-0200
  • Fax: 425-885-7601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number9366
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE00009366
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: