Individual
MS. HOLLY LYNN DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
182 SW ACADEMY ST STE 302, DALLAS, OR 97338-1900
(603) 623-8175
(503) 831-3499
Mailing address
182 SW ACADEMY STREET SUITE 302, DALLAS, OR 97338
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
200941130RN
OR
Other
Enumeration date
11/20/2014
Last updated
11/20/2014
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