Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | H6551 | OR |
NPI | 1083037071 |
---|---|
Provider Name | Kindee Ramirez |
First Address | Bend, OR 97701-9443 |
Second Address | Bend, OR 97701-9443 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2014 |
Last Update Date | 27/01/2014 |