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NPI Code Detail

MEDICARE: MARILYN RODRIGUEZ-FERNANDINI DDS

MEDICARE: MARILYN RODRIGUEZ-FERNANDINI 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
11223G0001XGeneral Practice DentistryDE00008203WA

Other Identifiers

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

General Provider Information

NPI Number : 1891871349
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARILYN RODRIGUEZ-FERNANDINI DDS
Provider Business Mailing Address
First Line : PO BOX 34703
Second Line :
City : SEATTLE
State : WA
Zip : 98124-1703
Country : US
Telephone Number : 206-764-0112
Fax Number : 206-764-0489
Provider Business Practice Location Address
First Line : 1412 NE 88TH ST
Second Line :
City : VANCOUVER
State : WA
Zip : 98665-9620
Country : US
Telephone Number : 360-574-4074
Fax Number : 360-574-9237
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2006
Last Update Date : 07/09/2007

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Directions to “ MARILYN RODRIGUEZ-FERNANDINI DDS” Practice Location

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