Individual
KATHERINE I DETRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
822 NE 181ST AVE, PORTLAND, OR 97230-6708
(503) 661-5210
(503) 669-3989
Mailing address
38320 MILLER RD, SANDY, OR 97055-6317
(503) 668-5495
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H1844
OR
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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