Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | H6584 | OR |
NPI | 1023447828 |
---|---|
Provider Name | Melody Mcgee |
First Address | Forest Grove, OR 97116-1296 |
Second Address | Forest Grove, OR 97116-2270 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2013 |
Last Update Date | 04/01/2022 |