Individual
JORIA VALENE KOONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, RDH
Contact information
Practice address
4926 S CORBETT AVE APT 101, PORTLAND, OR 97239-3918
(319) 242-1632
Mailing address
4926 S CORBETT AVE APT 101, PORTLAND, OR 97239-3918
(319) 242-1632
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
H7985
OR
133V00000X
Registered Dietitian
Primary
LD-D-10222347
OR
Other
Enumeration date
09/07/2022
Last updated
09/07/2022
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