Individual
MADELYN WOOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
13023 SE 84TH AVE STE A, CLACKAMAS, OR 97015-9798
(503) 353-9992
Mailing address
13624 SE 97TH AVE, CLACKAMAS, OR 97015-8648
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
DH60979128
WA
124Q00000X
Dental Hygienist
Primary
H7891
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H7891
OREGON BOARD OF DENTISTRY
OR
Enumeration date
08/19/2020
Last updated
08/19/2020
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