Individual
GWEN HRYCIW EICHENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD, PHD
Contact information
Practice address
12889 NW CORNELL RD, PORTLAND, OR 97229-5813
(503) 643-6643
Mailing address
14820 NW RIDGETOP CT, BEAVERTON, OR 97006-5404
(503) 888-8966
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11667
OR
Other
Enumeration date
08/10/2022
Last updated
01/20/2026
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