Healthcare Provider Details

I. General information

NPI: 1447826334
Provider Name (Legal Business Name): TRACI SAITO DMD, MS, MHA, PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SE 120TH AVE STE 900
VANCOUVER WA
98683-4094
US

IV. Provider business mailing address

300 SE 120TH AVE STE 900
VANCOUVER WA
98683-4094
US

V. Phone/Fax

Practice location:
  • Phone: 360-256-7220
  • Fax:
Mailing address:
  • Phone: 360-256-7220
  • Fax: 360-253-2907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. TRACI SAITO
Title or Position: OWNER
Credential: DMD
Phone: 360-256-7220