| Organization Name: | EMMA ETEMADI, DDS, PS |
| NPI Number: | 1811264005 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EMMA KATE ETEMADI (OWNER) |
| Mailing Address: | 14142 Main St Ne Suite 104 Duvall |
| State: | WA US |
| Postal Code: | 980199007 |
| Phone Number: | 4258025806 |
| Fax Number: | |
| NPI Enumeration Date: | 11/16/2011 |
| NPI Last Update Date: | 11/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DE00010166 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |