Individual
LEAH DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DA
Contact information
Practice address
10102 NE GLISAN ST, PORTLAND, OR 97220-4456
(503) 813-2000
Mailing address
6623 SE 136TH AVE, PORTLAND, OR 97236-4683
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
121800
OR
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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