Individual
REBECCA ARDATH BASL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
530 NW 27TH ST, CORVALLIS, OR 97330-5223
(541) 409-3455
Mailing address
530 NW 27TH ST, CORVALLIS, OR 97330-5223
(541) 409-3455
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
05/10/2022
Last updated
05/10/2022
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