Healthcare Provider Details
I. General information
NPI: 1568062701
Provider Name (Legal Business Name): KARLA AYLEN, DDS, PS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/27/2020
Last Update Date: 05/17/2021
Certification Date: 05/17/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11066 5TH AVE NE STE 208
SEATTLE WA
98125-6156
US
IV. Provider business mailing address
11066 5TH AVE NE STE 208
SEATTLE WA
98125-6156
US
V. Phone/Fax
- Phone: 206-362-1516
- Fax:
- Phone: 206-362-1516
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223P0300X |
| Taxonomy | Periodontics |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223P0700X |
| Taxonomy | Prosthodontics |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
SANDRA
HACHLER
Title or Position: RECEPTIONIST
Credential:
Phone: 425-344-9848