Ms. Mary Agnes Gubala
Dental Hygienist
12711 Se Mill Plain Blvd
Vancouver
, Washington 98684-6053
Ms. Mary Agnes Gubala
Dental Hygienist
12711 Se Mill Plain Blvd
Vancouver
, Washington 98684-6053
(360) 896-4484
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About
Features
Specialties
- Dental Hygienist
Languages spoken
- English
Location
First Address
- Ms. Mary Agnes Gubala
- 12711 Se Mill Plain Blvd
- Vancouver, WA
- Zip : 98684-6053
- Phone : (360) 896-4484
Second Address
- Ms. Mary Agnes Gubala
- 12711 Se Mill Plain Blvd
- Vancouver, WA
- Zip : 98684-6053
- Phone : (360) 896-4484
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | DH00002032 | WA |
National Provider Identifier
| NPI | 1023110087 |
|---|---|
| Provider Name | Ms. Mary Agnes Gubala |
| First Address | Vancouver, WA 98684-6053 |
| Second Address | Vancouver, WA 98684-6053 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/09/2006 |
| Last Update Date | 26/09/2012 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.