Individual
TERRY TAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10535 NE GLISAN ST, PORTLAND, OR 97220-4077
(503) 444-2824
Mailing address
10535 NE GLISAN ST, PORTLAND, OR 97220-4077
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H7704
OR
Other
Enumeration date
10/10/2019
Last updated
10/10/2019
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