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Individual

MRS. DARYN ANN SECRIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
5025 SE 28TH AVE, PORTLAND, OR 97202-4445
(503) 238-4418
Mailing address
1406 SE CONDOR PLACE, GRESHAM, OR 97080
(503) 661-0530

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H1199
OR

Other

Enumeration date
09/28/2006
Last updated
07/08/2007
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