Individual ProviderGrant F. RodkeyDentistDental ProvidersPractice Address850 Maple Street, Eastern State Hospital, Medical Lake, WA 99022-0800(509) 565-4000PECOS EnrollmentBased on the most recent information from CMS, provider Grant F. Rodkey does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1174739452Provider TypeIndividualFull NameRodkey, Grant F.TitleDr.CredentialDMDGenderMaleSole ProprietorYesEnumeration Date5/15/2007Last Updated11/23/2016Contact InformationPractice LocationPractice Address850 Maple Street, Eastern State Hospital, Medical Lake, WA 99022-0800Phone(509) 565-4000Fax(509) 565-4705Mailing LocationMailing AddressPO Box 800, Eastern State Hospital, Medical Lake, WA 99022-0800Phone(509) 565-4000Fax(509) 565-4705Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicenseDE00008198WashingtonCode1223G0001XDescriptionDentistDental ProvidersLicenseD3337IdahoCode1223G0001XDescriptionDentistDental ProvidersLicenseD7434Oregon