Reagan Ravanzo Blanco
Dental Assistant
4855 Sw Western Ave
Beaverton
, Oregon 97005-3460
Reagan Ravanzo Blanco
Dental Assistant
4855 Sw Western Ave
Beaverton
, Oregon 97005-3460
(971) 227-8773
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About
Features
Specialties
- Dental Assistant
Languages spoken
- English
Location
First Address
- Reagan Ravanzo Blanco
- 1771 Se Dowery Ln
- Hillsboro, OR
- Zip : 97123-5090
- Phone : (971) 227-8773
Second Address
- Reagan Ravanzo Blanco
- 4855 Sw Western Ave
- Beaverton, OR
- Zip : 97005-3460
- Phone : (503) 813-2000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 126800000X | Dental Assistant | 122012 | OR |
National Provider Identifier
| NPI | 1043857105 |
|---|---|
| Provider Name | Reagan Ravanzo Blanco |
| First Address | Hillsboro, OR 97123-5090 |
| Second Address | Beaverton, OR 97005-3460 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/12/2019 |
| Last Update Date | 06/12/2019 |
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.