Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DE00010356 | WA |
NPI | 1073789822 |
---|---|
Provider Name | Dr. Mariella Tatiana Garcia |
First Address | Seattle, WA 98121-4100 |
Second Address | Seattle, WA 98115-8158 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2008 |
Last Update Date | 10/01/2013 |