Individual
MICHELLE ANN VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
10209 SE SUNNYSIDE RD., CLACKAMAS, OR 97015
(503) 353-3900
(503) 353-3903
Mailing address
12345 SE BYBEE BLVD, PORTLAND, OR 97236-5013
(971) 344-3732
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6304
OR
126800000X
Dental Assistant
113959
OR
Other
Enumeration date
04/19/2007
Last updated
09/25/2012
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