MEDICARE: DR. TRACI SAITO DMD, MS, MHA

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	122300000X	Dentist	D10077	OR
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	D10077	OR
3	122300000X	Dentist	D009350	AZ

General Provider Information

NPI Number	:	1750790515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRACI SAITO DMD, MS, MHA

Provider Business Mailing Address
First Line	:	300 SE 120TH AVE STE 900
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98683-4094
Country	:	US
Telephone Number	:	360-256-7220
Fax Number	:	360-253-2907

Provider Business Practice Location Address
First Line	:	300 SE 120TH AVE STE 900
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98683-4094
Country	:	US
Telephone Number	:	360-256-7220
Fax Number	:	360-253-2907

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

Provider Enumeration Date	:	08/06/2014
Last Update Date	:	01/05/2026

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