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General NPI Number Information
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NPI Number | 1952815540
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Entity Type | Individual
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Provider Name | MARIAM TARIRI DDS
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Gender | Female
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Dates
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Enumeration Date | 11/20/2017
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Last Update Date | 11/20/2017
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Provider Practice Location Address
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Address Line | 12403 106TH PL NE
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City | KIRKLAND
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State | WA
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Zip | 98034-2861
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Country | US
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Telephone | 425-753-5369
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Fax |
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Provider Business Mailing Address
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Address Line | 19820 SCRIBER LAKE RD STE 2
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City | LYNNWOOD
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State | WA
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Zip | 98036-6121
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Country | US
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Telephone |
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 60772680
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License Number State | WA
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