Individual
KIMBERLY MISAKO TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EFDA, EFODA
Contact information
Practice address
1900 MCLOUGHLIN BLVD STE 68, OREGON CITY, OR 97045-1072
(503) 387-8000
(503) 387-8005
Mailing address
1900 MCLOUGHLIN BLVD STE 68, OREGON CITY, OR 97045-1072
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126800000X
PTDA
OR
Enumeration date
09/15/2011
Last updated
09/15/2011
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