Individual
STACIE THERING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
4404 NE 83RD AVE, PORTLAND, OR 97220-4931
(503) 475-8551
Mailing address
4404 NE 83RD AVE, PORTLAND, OR 97220-4931
(503) 475-8551
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6997
OR
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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