Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DE6051971 | WA |
N | 1223D0001X | Dental Public Health | DE60561971 | WA |
NPI | 1487062360 |
---|---|
Provider Name | Emily Lin |
First Address | Renton, WA 98057-2908 |
Second Address | Bothell, WA 98011-3205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2014 |
Last Update Date | 30/04/2020 |