Individual
NANCY LO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1314 NE GRAND AVE, PORTLAND, OR 97232
(503) 286-6868
Mailing address
332 NE 45TH AVE, PORTLAND, OR 97213-2311
(503) 747-8709
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H5913
OR
Other
Enumeration date
11/16/2013
Last updated
08/10/2018
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