Individual
MADELYN MARIE HAMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
10822 ENCHANTED WAY SE, JEFFERSON, OR 97352-9603
(503) 999-4719
Mailing address
10822 ENCHANTED WAY SE, JEFFERSON, OR 97352-9603
(503) 999-4719
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H5055
OR
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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