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1588771885
ALISA ANN PROUDFOOT
BEAVERTON, OR
NPI
1588771885
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Former Name
ALISA ANN SEGER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
124Q00000X Dental Hygienist
(Licence: OR H2484)
Enumeration Date
2006-08-23
Last Update Date
2007-07-16
Business Address
Mrs. ALISA ANN PROUDFOOT R.D.H.
4855 SW WESTERN AVE
BEAVERTON, OR 97005-3460
Phone number: 503-626-4148
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Mailing Address
Mrs. ALISA ANN PROUDFOOT R.D.H.
4855 SW WESTERN AVE
BEAVERTON, OR 97005-3460
Phone number: 503-626-4148
Copy
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