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General NPI Number Information
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NPI Number | 1376598847
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Entity Type | Organization
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Legal Business Name | JASON PEHLING DDS MS PC
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 04/25/2012
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Provider Practice Location Address
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Address Line | 2111 N NORTHGATE WAY STE 221
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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 | 206-363-8240
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Fax | 206-363-8301
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Provider Business Mailing Address
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Address Line | 2111 N NORTHGATE WAY STE 221
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City | SEATTLE
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State | WA
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Zip | 98133
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Country | US
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Telephone | 206-363-8240
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Fax | 206-363-8301
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JASON P PEHLING
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Credential | DDS MS
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Telephone | 206-363-8240
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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 | DE00008992
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License Number State | WA
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