Healthcare Provider Details

I. General information

NPI: 1316635600
Provider Name (Legal Business Name): JAMES MYHRE LE DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2023
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 QUEEN ANNE AVE N
SEATTLE WA
98109-2548
US

IV. Provider business mailing address

14424 MADISON WAY UNIT G3
LYNNWOOD WA
98087-1001
US

V. Phone/Fax

Practice location:
  • Phone: 206-204-5265
  • Fax:
Mailing address:
  • Phone: 714-804-7348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number109444
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDENT.DE.70083703
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: