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General NPI Number Information
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NPI Number | 1922138361
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Entity Type | Individual
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Provider Name | JACK HOU D.D.S., M.D,S.
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 09/30/2019
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Provider Practice Location Address
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Address Line | 411 STRANDER BLVD SUITE 102
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City | TUKWILA
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State | WA
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Zip | 98188-2935
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Country | US
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Telephone | 206-575-1194
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Fax | 206-575-3194
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Provider Business Mailing Address
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Address Line | 411 STRANDER BLVD SUITE 102
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City | TUKWILA
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State | WA
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Zip | 98188-2935
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Country | US
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Telephone | 206-575-1194
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Fax | 206-575-3194
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DE00010474
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License Number State | WA
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