DR. Larae Van Derschelden

NPI #1740365873 in Bothell, Washington

Provider Information

NPI Number: 1740365873
Entity Type: Individual
Name: DR. Larae Van Derschelden
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Enumeration Date: Oct 26, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 17917 BOTHELL EVERETT HWY
Address 2: SUITE 305
City: Bothell
State: Washington
ZIP Code: 98012-6384
Phone: (425) 481-1038

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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