# THALIA-RAE CRIDDLE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Criddle Concierge
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063181709
- **Authorized official:** THALIA-RAE CRIDDLE DMD (OWNER)
- **Authorized official phone:** (617) 762-6661

## Contact information

- **Practice address:** 1625 SE 192ND AVE STE 205, CAMAS, WA 98607-7441
- **Practice address phone:** (617) 762-6661
- **Mailing address:** 5781 SW CLAY CT, PORTLAND, OR 97221-1438
- **Mailing address phone:** (617) 762-6661

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/07/2021
- **Last updated:** 05/02/2024