Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | 10206499 | OR |
NPI | 1316576341 |
---|---|
Provider Name | Ms. Madeline M Cain |
First Address | Hillsboro, OR 97124-3048 |
Second Address | Hillsboro, OR 97124-3048 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2020 |
Last Update Date | 02/04/2020 |