Individual
MRS. JAN L LANDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EFDA
Contact information
Practice address
7201 N INTERSTATE AVE, PORTLAND, OR 97217-5523
(503) 240-4051
(503) 286-6876
Mailing address
8065 SW FAIRWAY DR, WILSONVILLE, OR 97070-6431
(503) 240-4051
(503) 286-6876
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
A0038
OR
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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