Individual
DR. TRAVIS ROYCE BASKERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
12116 SE MILL PLAIN BLVD, VANCOUVER, WA 98684
(360) 256-8200
Mailing address
503 N 41ST AVE, RIDGEFIELD, WA 98642-8074
(503) 709-9322
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
60772184
WA
Other
Enumeration date
05/28/2017
Last updated
08/20/2018
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