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1013066976
JEAN RAE CUSTER
PORTLAND, OR
NPI
1013066976
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
124Q00000X Dental Hygienist
(Licence: OR 1255)
Enumeration Date
2007-01-09
Last Update Date
2007-07-08
Business Address
-- JEAN RAE CUSTER RDH
10317 E BURNSIDE ST 2ND FLOOR
PORTLAND, OR 97216-2733
Phone number: 503-988-3905
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Mailing Address
-- JEAN RAE CUSTER RDH
710 SW 6TH CT
PORTLAND, OR 97219-6562
Phone number: 503-293-2895
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