Organization
OSA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RACHEL HOGAN DMD (OWNER)
(503) 860-0150
Entity
Organization
Contact information
Practice address
2730 SW MOODY AVE, PORTLAND, OR 97201-5042
(503) 860-0150
Mailing address
2730 SW MOODY AVE, PORTLAND, OR 97201-5042
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/16/2019
Last updated
05/29/2019
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