Mikayla E Alonzo, RDH
Individual provider Active NPI Dental Hygienist · Othello, WA
NPI 1003593294 · NPPES record last updated Jun 29, 2023
Key facts
- NPI
- 1003593294
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- DH61462182 (WA)
- Practice address
- 1515 E Columbia St
Othello, WA 99344-1846 - Phone
- (509) 488-5256
- Fax
- (509) 488-9939
- NPI assigned
- Jun 29, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DH61462182 | WA | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH61462182 | WA | Yes |
Addresses
Primary practice location
1515 E Columbia St
Othello, WA 99344-1846
Mailing address
1515 E Columbia St
Othello, WA 99344-1846
Phone (509) 488-5256
Other practice location 1
601 Government Rd
Mattawa, WA 99349-5120
Phone (509) 488-5256
Other practice location 2
1051 Columbia Ave
Connell, WA 99326-8702
Phone (509) 488-5256
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DH61462182 | Other | WA | DEPT. OF HEALTH |
Other providers in Othello, WA
- Adams County Public Hospital District 3
- Admas County Pulic Hospital No. 3
- Ana K Aguirre Monday
- Ahmed Al Rawe
- Luis Carlos Alcalde
- Octavio Alvarez Nunez
- Josue Abraham Alvarez
- Melissa Alvarez
- Natalie Andersen
- Maria Guadalupe Arceno
All providers in Othello, WA · Dental Hygienist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.