Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH60783015 | WA |
NPI | 1053876672 |
---|---|
Provider Name | Priyanka Handa |
First Address | Edmonds, WA 98026-5144 |
Second Address | Edmonds, WA 98026-5144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2019 |
Last Update Date | 07/02/2019 |