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Organization
KAISER PERMANENTE
Active
Organization
KAISER PERMANENTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS KOSAR SAAD MEMAN EFDA EFODA (ASSISTANT)
(503) 688-4601
Entity
Organization
Contact information
Practice address
7105 SW HAMPTON ST, TIGARD, OR 97223-8314
(503) 684-9274
Mailing address
4302 SW VACUNA ST, PORTLAND, OR 97219-7368
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
120925
OR
Other
Enumeration date
03/04/2013
Last updated
03/04/2013
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