Provider Demographics
NPI:1366928319
Name:DOPPEL, DIANE (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:
Last Name:DOPPEL
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 OLIVE WAY STE 920
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1840
Mailing Address - Country:US
Mailing Address - Phone:206-682-1654
Mailing Address - Fax:206-682-1190
Practice Address - Street 1:720 OLIVE WAY STE 920
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1840
Practice Address - Country:US
Practice Address - Phone:206-682-1654
Practice Address - Fax:206-682-1190
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA000064611223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics