Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | H5485 | OR |
NPI | 1013144609 |
---|---|
Provider Name | Yadira Martinez |
First Address | Cornelius, OR 97113-0568 |
Second Address | Hillsboro, OR 97123-4245 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2009 |
Last Update Date | 14/07/2016 |