Individual
SAMANTHA FORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17675 SW TUALATIN VALLEY HWY, BEAVERTON, OR 97003-4443
(503) 259-3160
Mailing address
10514 SW NAEVE ST, TIGARD, OR 97224-3516
(503) 598-9206
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
OR
Other
Enumeration date
10/27/2015
Last updated
10/27/2015
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