Individual
ANTONINA KUTSAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7201 N INTERSTATE AVE, PORTLAND, OR 97217-5523
(503) 286-6860
Mailing address
8613 NE 97TH CT, VANCOUVER, WA 98662-4227
(360) 949-8409
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
121171
OR
Other
Enumeration date
04/24/2018
Last updated
04/24/2018
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