Individual
KATIE LYNN FAULKNER
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
(503) 255-3114
Mailing address
13255 SE STARK ST, PORTLAND, OR 97233-1548
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6374
OR
Other
Enumeration date
01/22/2013
Last updated
01/22/2013
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