Healthcare Provider Details

I. General information

NPI: 1831140615
Provider Name (Legal Business Name): EDWARD ELIOT DASHOW DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 12/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 MARTIN LUTHER KING JR WAY 402
TACOMA WA
98405-4250
US

IV. Provider business mailing address

10807 EVERGREEN TER SW
LAKEWOOD WA
98498-6701
US

V. Phone/Fax

Practice location:
  • Phone: 253-552-1037
  • Fax:
Mailing address:
  • Phone: 253-584-8695
  • Fax: 253-552-1789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number00921
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: