SALLY D WIEDEMAN

PORTLAND, OR
NPI1427420470
Former NameSALLY D BEACH
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy124Q00000X Dental Hygienist
(Licence: OR  H6804)
Enumeration Date2015-10-28
Last Update Date2023-08-30
Business Address
SALLY D WIEDEMAN RDH
12750 SE STARK ST BLDG E
PORTLAND, OR 97233-1539
Phone number: 971-347-3009
Mailing Address
SALLY D WIEDEMAN RDH
1776 SW MADISON ST
PORTLAND, OR 97205-1715
Phone number: 503-224-1044
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