Individual
AZITA ZADEH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTDA
Contact information
Practice address
17803 NW DEERFIELD DR, PORTLAND, OR 97229-1778
(503) 614-8579
Mailing address
17803 NW DEERFIELD DR, PORTLAND, OR 97229-1778
(503) 614-8579
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
114606
OR
Other
Enumeration date
08/10/2006
Last updated
07/08/2007
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