Individual
MIRYAM GALLARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
216 SE 162ND AVE APT 38, PORTLAND, OR 97233-3839
(503) 803-7283
Mailing address
216 SE 162ND AVE APT 38, PORTLAND, OR 97233-3839
(503) 803-7282
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
07/06/2020
Last updated
07/06/2020
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