Individual
MS. STACEY LYNN RITALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
15962 SW TUALATIN-SHERWOOD RD., SHERWOOD, OR 97140
(503) 625-3767
Mailing address
15962 SW TUALATIN-SHERWOOD RD., SHERWOOD, OR 97140
(503) 625-3767
(503) 625-6956
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H4090
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H4090
DENTAL HYGIENE LICENSE OREGON BOARD OF DENTISTRY
OR
Enumeration date
10/12/2012
Last updated
10/12/2012
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