Individual
MITRA GASPEED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8615 SW THOROUGHBRED PL, BEAVERTON, OR 97008-7200
(971) 322-9504
Mailing address
8615 SW THOROUGHBRED PL, BEAVERTON, OR 97008-7200
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H4642
OR
Other
Enumeration date
09/06/2016
Last updated
09/06/2016
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