| NPI | 1326745795 |
|---|---|
| Doing Business As | PERIODONTICS NORTHWEST |
| Entity Type | Organization |
| Authorized Contact | FADI SHAYA Periodontist 503-915-0277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2023-02-15 |
| Last Update Date | 2023-02-15 |