Individual
TANYA KORNUTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
16755 SW BASELINE RD, 106, BEAVERTON, OR 97006
(503) 533-4001
Mailing address
21919 NE HEARTWOOD CIR, FAIRVIEW, OR 97024-6790
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6746
OR
Other
Enumeration date
06/10/2015
Last updated
06/10/2015
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