Individual
JONI DIANE PORTMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
13255 SE STARK ST., PORTLAND, OR 97233
(503) 644-6444
Mailing address
6950 NE CAMPUS WAY, HILLSBORO, OR 97124-5611
(503) 644-6444
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1525
OR
Other
Enumeration date
11/26/2007
Last updated
11/26/2007
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