Individual
SHI LI LUO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
10209 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9782
(503) 286-6868
Mailing address
2743 SE 85TH AVE, PORTLAND, OR 97266-1523
(503) 467-6320
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H7695
OR
Other
Enumeration date
01/31/2020
Last updated
12/22/2021
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