Individual
JOCLYN THORNBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12000 SW 49TH AVE, HT206, PORTLAND, OR 97219-7132
(503) 977-4909
Mailing address
15592 SE CRESTWOOD DR, MILWAUKIE, OR 97267-4438
(503) 656-2715
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
0557
OR
Other
Enumeration date
04/18/2008
Last updated
04/18/2008
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