Individual
DANIELLE AMI PLOUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S., M.D.
Contact information
Practice address
11786 SW BARNES RD STE 110, PORTLAND, OR 97225-5926
(503) 444-6444
(503) 444-4243
Mailing address
11786 SW BARNES RD STE 110, PORTLAND, OR 97225-5926
(503) 444-6444
(503) 444-4243
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DR60650631
WA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
2024-00524
NC
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
D10939
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/04/2016
Last updated
08/22/2025
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