Individual
AVENA M FINKBONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DHAT
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
00001
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00001
LUMMI COMMUNITY HEALTH AIDE PROGRAM
WA
Enumeration date
01/04/2021
Last updated
01/04/2021
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