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Individual

JAMIE LEE STORY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DA

Contact information

Practice address
17675 SW TUALATIN VALLEY HWY, BEAVERTON, OR 97003-4443
(503) 259-3160
Mailing address
17675 SW TUALATIN VALLEY HWY, BEAVERTON, OR 97003-4443
(503) 259-3160

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
93-0798039
OR

Other

Enumeration date
12/03/2019
Last updated
12/03/2019
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