| NPI | 1871081778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILIYA A IGNASHOVA Epdh 503-502-0701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 125K00000X Advanced Practice Dental Therapist (Licence: OR H4218) |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2018-04-25 |