Individual
MOLLIE CHRISTINA TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
13255 SE STARK ST, PORTLAND, OR 97233-1548
(503) 255-1901
Mailing address
7654 SE LAKE RD, MILWAUKIE, OR 97267-2144
(503) 358-3386
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6992
OR
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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