Individual
MRS. KRISTIN A BAZOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
4855 SW WESTERN AVE, BEAVERTON, OR 97005-3499
(503) 626-4148
(503) 626-4412
Mailing address
19881 SW GROVE LN, BEAVERTON, OR 97007
(503) 628-9115
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H2588
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
334
KAISER PERMANENTE HEALTH
OR
Enumeration date
09/05/2006
Last updated
07/08/2007
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