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General NPI Number Information
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NPI Number | 1700054913
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Entity Type | Organization
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Legal Business Name | TRIPPEL & AUDIA, PLLC
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Dates
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Enumeration Date | 02/11/2008
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 14420 BEL RED RD STE 201
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City | BELLEVUE
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State | WA
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Zip | 98007-3930
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Country | US
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Telephone | 425-644-8000
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Fax | 425-644-4888
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Provider Business Mailing Address
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Address Line | 14420 BEL RED RD STE 201
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City | BELLEVUE
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State | WA
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Zip | 98007-3930
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Country | US
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Telephone | 425-644-8000
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Fax | 425-644-4888
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS TRIPPEL
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Credential | DDS
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Telephone | 425-644-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DE00009124
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DE0005495
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License Number State | WA
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