Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | D7D0714779 | OR |
N | 122400000X | Denturist | DN00000218 | WA |
NPI | 1568529998 |
---|---|
Provider Name | James Clifton Garbarino |
First Address | Hillsboro, OR 97124-5611 |
Second Address | Portland, OR 97224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 08/07/2007 |