Individual
KELLIE MICHIKO KAWASAKI-JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
62968 OB RILEY ROAD, SUITE 12, BEND, OR 97701
(855) 433-6825
Mailing address
6950 NE CAMPUS WAY, HILLSBORO, OR 97124-5611
(855) 433-6825
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D10873
OR
1223G0001X
General Practice Dentistry
Primary
D10873
OR
Other
Enumeration date
07/23/2018
Last updated
07/23/2018
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