Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | H6948 | OR |
NPI | 1063962207 |
---|---|
Provider Name | Sylvianna Marquez |
First Address | Hood River, OR 97031-0030 |
Second Address | Hood River, OR 97031-1956 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2016 |
Last Update Date | 12/10/2016 |