Healthcare Provider Details

I. General information

NPI: 1679678833
Provider Name (Legal Business Name): KATHRYN CAMERON WRIGHT DMD. MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12500 SE 2ND CIR SUITE 135
VANCOUVER WA
98684-6028
US

IV. Provider business mailing address

12500 SE 2ND CIR SUITE 135
VANCOUVER WA
98684-6028
US

V. Phone/Fax

Practice location:
  • Phone: 360-695-0994
  • Fax: 360-695-8994
Mailing address:
  • Phone: 360-695-0994
  • Fax: 360-695-8994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number6457
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: