Individual
UNTIMA NAVARAT NA AYUTTAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7105 SW HAMPTON ST, TIGARD, OR 97223-8314
(503) 286-6868
Mailing address
10638 SW CAPITOL HWY APT 12, PORTLAND, OR 97219-6865
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
11/23/2022
Last updated
11/23/2022
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