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General NPI Number Information
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NPI Number | 1295886422
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Entity Type | Individual
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Provider Name | MALINDA LAM GERSHONY D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 15955 NE 85TH ST #101
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City | REDMOND
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State | WA
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Zip | 98052-3550
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Country | US
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Telephone | 425-883-2933
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Fax | 425-885-0146
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Provider Business Mailing Address
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Address Line | 6628 188TH PL NE
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City | REDMOND
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State | WA
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Zip | 98052-8599
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Country | US
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Telephone | 425-885-9851
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Fax | 425-885-9851
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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 | DE9307
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License Number State | WA
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