Healthcare Provider Details

I. General information

NPI: 1912862194
Provider Name (Legal Business Name): DKEIDEK, FERNYHOUGH, GILE, HAGEL, NOV & QUICKSTAD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 LENORA ST STE 216
SEATTLE WA
98121-2753
US

IV. Provider business mailing address

900 LENORA ST STE 216
SEATTLE WA
98121-2753
US

V. Phone/Fax

Practice location:
  • Phone: 206-402-5490
  • Fax:
Mailing address:
  • Phone: 206-402-5490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DAWN MCCONKEY
Title or Position: RDO
Credential:
Phone: 772-559-5343