Pawlak, Derek T
Pawlak, Derek T is an individual health care provider with primary practice located at 161 Bay Lyn Dr , Lynden WA 98264-9404. He recently has only one registered license in Dental Providers / Denturist, which is considered as his primary health care specialty. Pawlak, Derek T can be contacted via phone (360) 318-0880.Contact Information
Primary practice address
161 Bay Lyn Dr
Lynden WA 98264-9404
Phone: (360) 318-0880
Fax: (360) 318-0880
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Denturist | 122400000X | 025108DN00000270 | Washington |
Profile Details
| NPI number | 1477548766 |
|---|---|
| LBN Legal business name | Pawlak, Derek T |
| Credentials | LD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 13th, 2005 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477548766 | NPPES |
| Washington | Other | 025108DN00000270 | DEPT OF HEALTH |
| Washington | MEDICAID | 5036017 | DEPT OF HEALTH |
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