Individual
IRENE KO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
7017 SW NYBERG ST, TUALATIN, OR 97062-6243
(503) 612-8736
Mailing address
3280 SW 170TH AVE, APT 1107, BEAVERTON, OR 97006-5077
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
DH1701
HI
124Q00000X
Dental Hygienist
DH60253012
WA
124Q00000X
Dental Hygienist
Primary
H6145
OR
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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