Individual
YVONNE OTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
10300 SE WASHINGTON ST STE C101, PORTLAND, OR 97216-2805
(037) 763-0915
Mailing address
1025 SE 11TH AVE, PORTLAND, OR 97214-2486
(802) 595-1758
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12203
OR
Other
Enumeration date
05/28/2025
Last updated
08/25/2025
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