Individual
MISS CHENOA MARIE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
9211 SE DIVISION ST, PORTLAND, OR 97266-1452
(503) 254-2068
Mailing address
9211 SE DIVISION ST, PORTLAND, OR 97266-1452
(503) 254-2068
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH60194052
WA
124Q00000X
Dental Hygienist
H5908
OR
Other
Enumeration date
08/08/2011
Last updated
06/22/2020
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