Individual
TACHELLE LYNNE BOWDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5025 SE 28TH AVE, PORTLAND, OR 97202-4445
(503) 238-4418
Mailing address
7026 N VANCOUVER AVE, PORTLAND, OR 97217-1749
(503) 238-4418
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
114922
OR
Other
Enumeration date
02/28/2007
Last updated
07/08/2007
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