Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH 00005922 | WA |
NPI | 1033669833 |
---|---|
Provider Name | Charity Rebecca Ashworth |
First Address | Vancouver, WA 98683-7209 |
Second Address | Vancouver, WA 98684-6053 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2016 |
Last Update Date | 23/12/2021 |