Basic Information
Provider Information
NPI: 1043524531
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EAST
FirstName: ALANA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: DDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4111 194TH ST SW
Address2: STE #201
City: LYNNWOOD
State: WA
PostalCode: 980364604
CountryCode: US
TelephoneNumber: 4258355204
FaxNumber: 4258355205
Practice Location
Address1: 4111 194TH ST SW
Address2: STE #201
City: LYNNWOOD
State: WA
PostalCode: 980364604
CountryCode: US
TelephoneNumber: 4258355204
FaxNumber: 4258355205
Other Information
ProviderEnumerationDate: 07/27/2010
LastUpdateDate: 08/05/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X60172181WAY Dental ProvidersDentist 

No ID Information.


Home