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General NPI Number Information
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NPI Number | 1699988808
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Entity Type | Organization
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Legal Business Name | BARRY A FEDER DDS PS
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 450 NW GILMAN BLVD SUITE 103
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City | ISSAQUAH
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State | WA
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Zip | 98027-2483
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Country | US
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Telephone | 425-392-7541
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Fax | 425-391-3869
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Provider Business Mailing Address
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Address Line | 450 NW GILMAN BLVD SUITE 103
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City | ISSAQUAH
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State | WA
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Zip | 98027-2483
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Country | US
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Telephone | 425-392-7541
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Fax | 425-391-3869
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Authorized Official
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Title or Position | OWNER
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Name | BARRY A FEDER
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Credential |
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Telephone | 425-392-7541
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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 | 4718
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License Number State | WA
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