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General NPI Number Information
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NPI Number | 1245595669
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Entity Type | Individual
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Provider Name | PEANUT WAI-PING WONG HATTAWAY DMD
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Gender | Female
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Dates
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Enumeration Date | 07/11/2012
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 16255 NE 87TH ST STE 150
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City | REDMOND
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State | WA
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Zip | 98052-7464
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Country | US
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Telephone | 425-883-8000
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Fax | 425-883-7580
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Provider Business Mailing Address
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Address Line | 955 POWELL AVE SW
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City | RENTON
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State | WA
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Zip | 98057-2908
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Country | US
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Telephone | 425-277-1311
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Fax | 425-277-1566
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 60284417
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE60284417
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License Number State | WA
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