Individual
REINA ESCUTIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EFODA
Contact information
Practice address
5910 ULALI DR NE, KEIZER, OR 97303-1500
(503) 813-2000
Mailing address
4422 RACCOON CT NE, SALEM, OR 97305-3081
(503) 851-1154
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
118110
OR
Other
Enumeration date
01/08/2020
Last updated
01/08/2020
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