Individual
MS. FAREN GABRIELLE CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1107 NE BURNSIDE, GRESHAM, OR 97030-5710
(360) 608-2665
Mailing address
1107 NE BURNSIDE, GRESHAM, OR 97030-5710
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
DH60304580
WA
124Q00000X
Dental Hygienist
Primary
H6334
OR
Other
Enumeration date
07/08/2013
Last updated
07/08/2013
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