Individual
MRS. LAINE CORINNE EWRY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
215 SE 102ND AVE, SUITE #200, PORTLAND, OR 97216-2700
(503) 253-4700
(503) 253-6597
Mailing address
6712 SE 114TH AVE, PORTLAND, OR 97266-4966
(503) 760-5463
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H4365
OR
Other
Enumeration date
06/04/2006
Last updated
07/08/2007
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