Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | H2051 | OR |
NPI | 1023488954 |
---|---|
Provider Name | Mrs. Sharon Lynne Brown |
First Address | Portland, OR 97232 |
Second Address | Portland, OR 97232 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2015 |
Last Update Date | 05/10/2015 |