Individual
KRISTINA PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
13000 SW 2ND ST, BEAVERTON, OR 97005-2615
(503) 259-5045
Mailing address
PO BOX 568, CORNELIUS, OR 97113-0568
(503) 352-8657
(503) 352-8658
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H7310
OR
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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