Individual
MISS RENEE JULIA LAWSON DEMALLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH, EPDH
Contact information
Practice address
511 SW 10TH AVE, SUITE 1214, PORTLAND, OR 97205
(503) 228-2531
Mailing address
511 SW 10TH AVE, SUITE 1214, PORTLAND, OR 97205
(503) 228-2531
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6491
OR
Other
Enumeration date
10/17/2013
Last updated
07/24/2014
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