Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 124Q00000X | Dental Hygienist | 1219 | MT |
Y | 124Q00000X | Dental Hygienist | H8044 | OR |
NPI | 1033467311 |
---|---|
Provider Name | Lorie Kay Becker |
First Address | Redmond, OR 97756-7039 |
Second Address | Redmond, OR 97756-7039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2012 |
Last Update Date | 07/10/2020 |