Individual
MICHELLE LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DH
Contact information
Practice address
1015 COLUMBIA, BRIDGEPORT, WA 98813
(509) 422-5700
Mailing address
PO BOX 1340, OKANOGAN, WA 98840-1340
(509) 689-2525
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
IL6058623
WA
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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