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General NPI Number Information
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NPI Number | 1558138800
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Entity Type | Organization
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Legal Business Name | HADI YOUSSEF DMD PLLC.
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Dates
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Enumeration Date | 12/07/2023
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 640 GOERIG ST
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City | WOODLAND
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State | WA
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Zip | 98674-9401
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Country | US
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Telephone | 971-231-5124
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Fax |
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Provider Business Mailing Address
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Address Line | 16913 NE 30TH ST
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City | VANCOUVER
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State | WA
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Zip | 98682-7313
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Country | US
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Telephone | 503-841-9113
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Fax |
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | HADI YOUSSEF
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Credential | DMD
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Telephone | 503-841-9113
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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 |
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License Number State |
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