Healthcare Provider Details

I. General information

NPI: 1588703219
Provider Name (Legal Business Name): RHYS D SPOOR DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 5TH AVE SUITE 4660
SEATTLE WA
98104-7097
US

IV. Provider business mailing address

701 5TH AVE SUITE 4660
SEATTLE WA
98104-7097
US

V. Phone/Fax

Practice location:
  • Phone: 206-682-8200
  • Fax: 206-386-5099
Mailing address:
  • Phone: 206-682-8200
  • Fax: 206-386-5099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE00005869
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: