Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | H6438 | OR |
NPI | 1073951489 |
---|---|
Provider Name | Ashley N Foster |
First Address | Castle Rock, WA 98611 |
Second Address | Portland, OR 97266 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2013 |
Last Update Date | 07/06/2013 |