Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | H7273 | OR |
NPI | 1033663489 |
---|---|
Provider Name | Sharon A Fought |
First Address | Washougal, WA 98671-7596 |
Second Address | Washougal, WA 98671-7596 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2016 |
Last Update Date | 28/10/2016 |