Individual
TYSEN KLAFKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.D.
Contact information
Practice address
975 SW 1ST AVE, ONTARIO, OR 97914-2112
(541) 889-3750
Mailing address
975 SW 1ST AVE, ONTARIO, OR 97914-2112
(541) 889-3750
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
10174720
OR
Other
Enumeration date
02/12/2016
Last updated
02/12/2016
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