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Individual

MS. BRANDY NICOLE MAYES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
1532 NE 21ST AVE, APT 207, PORTLAND, OR 97232-1566
(310) 497-9405
Mailing address
1532 NE 21ST AVE, APT 207, PORTLAND, OR 97232-1566
(310) 497-9405

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
00007926
WA
124Q00000X
Dental Hygienist
Primary
H5352
OR

Other

Enumeration date
11/05/2008
Last updated
11/05/2008
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