Individual
ANDREA ELIZABETH LEA COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
13831 NW CORNELL RD, PORTLAND, OR 97229-5485
(503) 718-3762
Mailing address
2080 NW FRONT AVE APT 108, PORTLAND, OR 97209-1858
(814) 602-0954
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10859
OR
Other
Enumeration date
07/19/2018
Last updated
07/19/2018
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