Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 1461 | OR |
NPI | 1073523403 |
---|---|
Provider Name | Ms. Jacqueline Ree Farlinger-King |
First Address | Portland, OR 97212-4150 |
Second Address | Portland, OR 97202-4445 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 08/07/2007 |