ANNETTE ALLISON TACKE (NPI# 1407192073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407192073 |
| Entity Type | Individual |
| Full Name | ANNETTE ALLISON TACKE |
| Credential | RDH |
| Practice Address |
115 Kirkland Rd Longview WA 98632-0701 |
| Practice Telephone | 2536530042 |
| Mailing Telephone | 2536530042 |
| Enumeration Date | 2012-12-29 |
| Last Update Date | 2012-12-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | DH00007476 | WA | Dental Providers |
| Street Address |
115 KIRKLAND RD |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-0701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
| 1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
| 1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
| 1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
| 1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518383942 | Mamie Lee | Dental Hygienist | 3565 Haliegh Pl, Longview, WA 98632-4778 | 2014-03-10 |
| 1861825150 | Christina Victoria Negrete | Dental Hygienist | 4400 Ocean Beach Hwy, Unit 3, Longview, WA 98632-5080 | 2013-08-09 |
| 1912019027 | Anita Louise Bach | Dental Hygienist | 1703 Hudson St, Longview, WA 98632-2912 | 2006-08-31 |
| 1073079984 | Lyndsey Smith | Dental Hygienist | 1057 12th Ave, Longview, WA 98632-2509 | 2019-02-15 |
| 1164958468 | Vera Gerega | Dental Hygienist | 2020 9th Ave Ste A, Longview, WA 98632-4072 | 2017-05-05 |
| 1134507767 | Kelly A Hollingshead | Dental Hygienist | 1230 7th Ave, Longview, WA 98632-3166 | 2015-05-15 |
| 1376899831 | Jana Michelle Anderson | Dental Hygienist | 911 11th Ave, Suite A, Longview, WA 98632-2547 | 2012-08-01 |
| 1952413817 | Daphne Marie Chadwick | Dental Hygienist | 1230 7th Ave, Longview, WA 98632-3166 | 2006-08-31 |
| 1134231228 | Donna Marie Jessen | Dental Hygienist | 1230 7th Ave, Longview, WA 98632-3166 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807755 | Karen Sloat Parker | Dental Hygienist | 1014 12th Ave N, Edmonds, WA 98020-2511 | 2020-10-05 |
| 1255948030 | Adisa Salaka | Dental Hygienist | 14335 Simonds Rd Ne Apt A303, Kirkland, WA 98034-9277 | 2020-09-25 |
| 1790391951 | Ann Marie O'connor | Dental Hygienist | 620 Glen St Apt 302, Edmonds, WA 98020-3236 | 2020-09-22 |
| 1396359691 | Lindsey Marie Tennant-moore | Dental Hygienist | 6515 5th Ave Ne Apt 202, Seattle, WA 98115-6451 | 2020-09-03 |
| 1356952568 | Stephanie Kleinbrook | Dental Hygienist | 1455 James St, Bellingham, WA 98225-4943 | 2020-08-11 |
| 1639789787 | Catrice Opichka | Dental Hygienist | 1118 Hilty Ln, Bow, WA 98232-9544 | 2020-08-04 |
| 1487272860 | Diedre Snow Hill | Dental Hygienist | 1950 Pottery Ave Ste 170, Port Orchard, WA 98366-2591 | 2020-07-11 |
| 1922621929 | Rebecca Rose | Dental Hygienist | 4532 Dyes Inlet Rd Nw, Bremerton, WA 98312-1410 | 2020-05-26 |
| 1053946673 | Jessica Maree Carnes | Dental Hygienist | 6505 Nw Cherry Street, Vancouver, WA 98663 | 2020-03-04 |
| 1952933251 | Julie Kristen Dutler | Dental Hygienist | 11572 C St, Jblm, WA 98433 | 2020-02-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.