Individual
MOLLY DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
16110 NW CENTINE LN, PORTLAND, OR 97229-1130
(503) 575-6544
(503) 466-1143
Mailing address
16110 NW CENTINE LN, PORTLAND, OR 97229-1130
(503) 575-6544
(503) 466-1143
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12655
OR
Other
Enumeration date
07/22/2010
Last updated
07/22/2010
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