Individual
MRS. SHANNON VUYLSTEKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EFDA
Contact information
Practice address
19075 NW TANASBOURNE DR, SUITE 300, HILLSBORO, OR 97124-5860
(503) 531-1700
Mailing address
267 N 10TH AVE, APT 31, CORNELIUS, OR 97113-9166
(503) 531-1700
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
10/09/2007
Last updated
10/25/2007
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