Individual
THERESA E MADDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
611 SW CAMPUS DR, ROOM 19, PORTLAND, OR 97239-3001
(503) 494-4316
(503) 494-8384
Mailing address
0220 SW TEXAS ST, PORTLAND, OR 97219-2342
(503) 638-0623
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D6849
OR
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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