MEDICARE: HARBOUR POINTE DENTAL ARTS

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1770442865
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARBOUR POINTE DENTAL ARTS

Provider Business Mailing Address
First Line	:	4112 HARBOUR POINTE BLVD SW STE 200
Second Line	:
City	:	MUKILTEO
State	:	WA
Zip	:	98275-5457
Country	:	US
Telephone Number	:	425-493-1300
Fax Number	:	425-493-9720

Provider Business Practice Location Address
First Line	:	4112 HARBOUR POINTE BLVD SW STE 200
Second Line	:
City	:	MUKILTEO
State	:	WA
Zip	:	98275-5457
Country	:	US
Telephone Number	:	425-493-1300
Fax Number	:	425-493-9720

Authorized Official
Title or Position	:	OWNER
Name	:	DARRELL EUGENE CLINE
Credential	:	DDS
Telephone Number	:	425-493-1300

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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Practice Location Address:

4112 HARBOUR POINTE BLVD SW , STE 100
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1912008913 — THOMAS K. HAFFORD MD
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4112 HARBOUR POINTE BLVD SW , SUITE 100
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1639270762 — KATHERINE D. BUMSTEAD MD
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4112 HARBOUR POINTE BLVD SW , SUITE 100
MUKILTEO, WA
98275-5457

Practice Phone: 425-347-6330
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1568644607 — DR. RAJASRI DHARANI PALEPU MD
Practice Location Address:

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1366602468 — POONAM RAUNIYAR MD
Practice Location Address:

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1124279237 — PROVIDENCE HEALTH & SERVICES - WASHINGTON
Practice Location Address:

4112 HARBOUR POINTE BLVD SW , SUITE 100
MUKILTEO, WA
98275-5457

Practice Phone: 425-347-6330
Practice Fax: 425-347-6335

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