Organization
WILLAMETTE DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDSEY KATHLEEN REEVES (DENTAL HYGIENIST)
(503) 444-1822
Entity
Organization
Contact information
Practice address
4925 SW GRIFFITH DR, BEAVERTON, OR 97005-2923
(503) 444-1822
Mailing address
4925 SW GRIFFITH DR, BEAVERTON, OR 97005-2923
(503) 444-1822
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
H6635
OR
Other
Enumeration date
05/29/2014
Last updated
05/29/2014
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