Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 120577 | OR |
NPI | 1154886877 |
---|---|
Provider Name | Mrs. Sarah Elizabeth Anderson Mills |
First Address | Tigard, OR 97223-4153 |
Second Address | Beaverton, OR 97005-3460 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2019 |
Last Update Date | 06/02/2019 |