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General NPI Number Information
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NPI Number | 1861656209
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Entity Type | Organization
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Legal Business Name | EVYENIA KOLLIA DMD PLLC
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Dates
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Enumeration Date | 07/15/2008
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Last Update Date | 04/11/2018
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Provider Practice Location Address
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Address Line | 2701 EASTLAKE AVE E # 104
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City | SEATTLE
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State | WA
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Zip | 98102-3104
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Country | US
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Telephone | 206-588-0714
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Fax | 206-588-0716
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Provider Business Mailing Address
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Address Line | 2701 EASTLAKE AVE E # 104
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City | SEATTLE
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State | WA
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Zip | 98102-3104
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Country | US
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Telephone | 206-588-0714
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Fax | 206-588-0716
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EVYENIA KOLLIA
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Credential | DMD
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Telephone | 206-743-5750
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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 | DE00010405
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License Number State | WA
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