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Individual

MS. FABIANA GARCIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
18139 NE COUCH ST, PORTLAND, OR 97230-7281
(503) 489-1760
Mailing address
18139 NE COUCH ST, PORTLAND, OR 97230-7281
(503) 489-1760

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
124Q00000X
OR

Other

Enumeration date
06/17/2016
Last updated
06/17/2016
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