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General NPI Number Information
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NPI Number | 1477096238
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Entity Type | Organization
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Legal Business Name | RICHARD Y MIYATA DDS PLLC
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Dates
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Enumeration Date | 11/28/2016
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Last Update Date | 12/13/2016
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Provider Practice Location Address
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Address Line | 310 HARVARD AVE E
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City | SEATTLE
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State | WA
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Zip | 98102-5421
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Country | US
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Telephone | 206-324-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 310 HARVARD AVE E
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City | SEATTLE
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State | WA
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Zip | 98102-5421
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Country | US
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Telephone | 206-324-1100
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | RICHARD MIYATA
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Credential | DDS
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Telephone | 206-323-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE7978
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License Number State | WA
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