Individual
MR. PATRICK STEVENS EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
E.F.D.A., R.D.A.
Contact information
Practice address
8728 N HAVEN AVE, PORTLAND, OR 97203-3426
(503) 309-2651
Mailing address
8728 N HAVEN AVE, PORTLAND, OR 97203-3426
(503) 309-2651
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
A30373
OR
126800000X
Dental Assistant
D1 60053125
WA
Other
Enumeration date
03/09/2012
Last updated
03/09/2012
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