Organization
VASH DENTAL MOBILE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NADEZHDA YURKO BS RDH (EPDH)
(503) 502-6525
Entity
Organization
Contact information
Practice address
1405 SE 168TH PL, PORTLAND, OR 97233-4409
(503) 502-6525
Mailing address
1405 SE 168TH PL, PORTLAND, OR 97233-4409
Taxonomy
Speciality
Code
Description
License number
State
125K00000X
Advanced Practice Dental Therapist
Primary
H4219
OR
Other
Enumeration date
04/26/2018
Last updated
04/26/2018
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