=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417805466
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SCOTT W.W. STEEDMAN, DDS, MPH, PS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/17/2026
-----------------------------------------------------
Last Update Date | 03/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 515 HWY 9 STE 101
-----------------------------------------------------
City | LAKE STEVENS
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98258-8523
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-334-4087
-----------------------------------------------------
Fax | 425-397-0399
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 515 HWY 9 STE 101
-----------------------------------------------------
City | LAKE STEVENS
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98258-8523
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-334-4087
-----------------------------------------------------
Fax | 425-397-0399
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST/OWNER
-----------------------------------------------------
Name | DR. SCOTT STEEDMAN
-----------------------------------------------------
Credential | DDS, MPH, PS
-----------------------------------------------------
Telephone | 425-334-4087
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------