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General NPI Number Information
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NPI Number | 1811760200
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Entity Type | Organization
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Legal Business Name | TD SALMON CREEK LLP
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Dates
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Enumeration Date | 11/06/2023
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 14201 NE 20TH AVE STE A101
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City | VANCOUVER
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State | WA
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Zip | 98686-6411
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Country | US
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Telephone | 360-667-5676
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Fax |
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Provider Business Mailing Address
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Address Line | 101 NW 12TH AVE STE 130
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City | BATTLE GROUND
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State | WA
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Zip | 98604-9145
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Country | US
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Telephone | 360-667-5676
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Fax | 360-723-0205
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CARLY PIERCE
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Credential |
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Telephone | 360-667-5676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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