Individual
ANN AMANDA WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2084 NE PROFESSIONAL CT, BEND, OR 97701-6077
(541) 383-3005
(541) 383-1883
Mailing address
600 SW COLUMBIA ST STE 6250, BEND, OR 97702-1099
(541) 323-3181
(541) 706-9897
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H7767
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H7767
DENTAL HYGIENIST LICENSE
OR
Enumeration date
08/30/2022
Last updated
08/30/2022
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