MEDICARE: DR. LUCY KEY DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DE00007700	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639188402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUCY KEY DDS

Provider Business Mailing Address
First Line	:	17808 2ND ST E
Second Line	:
City	:	LAKE TAPPS
State	:	WA
Zip	:	98391-6432
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17808 2ND ST E
Second Line	:
City	:	LAKE TAPPS
State	:	WA
Zip	:	98391-6432
Country	:	US
Telephone Number	:	253-348-5169
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	08/20/2012

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