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General NPI Number Information
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NPI Number | 1326745795
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Entity Type | Organization
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Legal Business Name | MAO & SHAYA PLLC
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Dates
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Enumeration Date | 02/15/2023
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Last Update Date | 02/15/2023
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Provider Practice Location Address
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Address Line | 2111 N NORTHGATE WAY STE 215
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City | SEATTLE
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State | WA
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Zip | 98133-9018
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Country | US
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Telephone | 206-367-6767
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Fax |
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Provider Business Mailing Address
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Address Line | 2111 N NORTHGATE WAY STE 215
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City | SEATTLE
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State | WA
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Zip | 98133-9018
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PERIODONTIST
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Name | DR. FADI SHAYA
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Credential | DMD, MSD
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Telephone | 503-915-0277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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