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Individual

TASHIA MONIQUE CRUMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
EFDA

Contact information

Practice address
530 NW 27TH ST, CORVALLIS, OR 97330-5223
(541) 766-6835
Mailing address
530 NW 27TH ST, CORVALLIS, OR 97330-5223
(541) 766-6835

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
123573
OR

Other

Enumeration date
04/29/2020
Last updated
04/29/2020
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