Individual
DR. ERICA S WALDAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
12710 SE DIVISION ST, PORTLAND, OR 97236-3134
(503) 988-3410
Mailing address
1314 NW IRVING ST, #706, PORTLAND, OR 97209-2721
(503) 243-7955
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8714
OR
Other
Enumeration date
10/18/2006
Last updated
07/08/2007
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