Individual
MRS. TAMARA LARAE COPPEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EFDA,PTDA
Contact information
Practice address
7105 SW HAMPTON ST, TIGARD, OR 97223-8314
(503) 684-9274
(503) 624-9610
Mailing address
21540 SW GREGORY DR, BEAVERTON, OR 97006-6450
(503) 645-7766
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
08/29/2006
Last updated
07/08/2007
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