Provider Demographics
NPI:1548909948
Name:DEMIAN WOYCIEHOWSKY, DMD, PLLC
Entity type:Organization
Organization Name:DEMIAN WOYCIEHOWSKY, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEMIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOYCIEHOWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:360-567-5064
Mailing Address - Street 1:4214 NE 136TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-7162
Mailing Address - Country:US
Mailing Address - Phone:360-567-5064
Mailing Address - Fax:
Practice Address - Street 1:155 NE 192ND AVE STE 105
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-7477
Practice Address - Country:US
Practice Address - Phone:360-567-5064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental