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Individual

AUDREY LOUISE DEVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DA

Contact information

Practice address
12750 SE STARK ST BLDG E, PORTLAND, OR 97233-1539
(971) 347-3009
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(503) 224-1044
(971) 260-0355

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
1128845
OR
126800000X
Dental Assistant
D160914067
WA

Other

Enumeration date
10/02/2024
Last updated
06/03/2025
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