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Individual

JAYCEE AMANDA COPHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
365 WARNER MILNE RD, OREGON CITY, OR 97045-4073
(971) 206-7115
Mailing address
365 WARNER MILNE RD STE 110, OREGON CITY, OR 97045-4073
(971) 206-7115

Taxonomy

Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
D0003
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DT0003
OR
Enumeration date
02/22/2023
Last updated
09/06/2023
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