Healthcare Provider Details
I. General information
NPI: 1326656216
Provider Name (Legal Business Name): JOSHUA YUKI ALUMBAUGH DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/17/2020
Last Update Date: 07/28/2021
Certification Date: 07/02/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US
IV. Provider business mailing address
6367 NE RADFORD DR APT 4028
SEATTLE WA
98115-8723
US
V. Phone/Fax
- Phone: 206-762-1010
- Fax:
- Phone: 425-922-8504
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 204E00000X |
| Taxonomy | Oral & Maxillofacial Surgery (D.M.D.) |
| License Number | DR61161224 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: