| NPI | 1679061584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADEZHDA YURKO Epdh 503-502-6525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 125K00000X Advanced Practice Dental Therapist (Licence: OR H4219) |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2018-04-26 |