Individual
BAILEY RENEE BUSHUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1314 NE GRAND AVE, PORTLAND, OR 97232-1127
(503) 286-6868
Mailing address
470 SHAFER LN, JACKSONVILLE, OR 97530-9694
(541) 306-8019
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H5790
OR
Other
Enumeration date
07/24/2012
Last updated
12/18/2013
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