Individual
JONALEE COZAKOS POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
44 N 11TH AVE, CORNELIUS, OR 97113-9020
(503) 359-8505
(503) 434-8597
Mailing address
PO BOX 6149, BEAVERTON, OR 97007-0149
(503) 359-8501
(503) 434-8597
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
111930-9920
UT
124Q00000X
Dental Hygienist
DH-1678
ID
124Q00000X
Dental Hygienist
Primary
H1907
OR
124Q00000X
Dental Hygienist
HL00007676
WA
Other
Enumeration date
08/07/2007
Last updated
02/11/2019
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