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General NPI Number Information
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NPI Number | 1962853655
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Entity Type | Individual
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Provider Name | MICHITSUNA KATAFUCHI DDS, MSD, PH.D
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Gender | Male
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Dates
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Enumeration Date | 06/24/2016
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 12911 120TH AVE NE STE F240
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City | KIRKLAND
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State | WA
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Zip | 98034-3054
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Country | US
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Telephone | 425-820-2414
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Fax |
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Provider Business Mailing Address
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Address Line | 1270 140TH PL NE
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City | BELLEVUE
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State | WA
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Zip | 98007-4049
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Country | US
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Telephone | 206-849-2970
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DE 60662789
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License Number State | WA
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