Individual
MANIZHA REZAYEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
5520 N INTERSTATE AVE # UNITS12, PORTLAND, OR 97217-4526
(503) 734-2494
Mailing address
9488 SE GRACE CIR, HAPPY VALLEY, OR 97086-5009
(503) 405-2236
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11499
OR
Other
Enumeration date
08/10/2021
Last updated
08/10/2021
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