Individual
DR. JIYOUNG ELIZABETH LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
831 NW COUNCIL DR STE 210, GRESHAM, OR 97030-3724
(503) 666-9436
(503) 912-0757
Mailing address
831 NW COUNCIL DR STE 210, GRESHAM, OR 97030-3724
(503) 666-9436
(503) 912-0757
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
20808
MA
1223P0221X
Pediatric Dentistry
Primary
D8776
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028475
OMAP
OR
Enumeration date
07/28/2006
Last updated
06/15/2020
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