Individual
PETER MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14406 NE 20TH AVE, VANCOUVER, WA 98686-1448
(503) 571-3139
Mailing address
5830 NE ALBERTA ST, PORTLAND, OR 97218-2621
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
NA
OR
Other
Enumeration date
05/31/2017
Last updated
05/17/2022
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