Organization
VASH DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILIYA A IGNASHOVA (EPDH)
(503) 502-0701
Entity
Organization
Contact information
Practice address
623 NE 160TH AVE, PORTLAND, OR 97230-5702
(503) 502-0701
Mailing address
623 NE 160TH AVE, PORTLAND, OR 97230-5702
Taxonomy
Speciality
Code
Description
License number
State
125K00000X
Advanced Practice Dental Therapist
Primary
H4218
OR
Other
Enumeration date
04/25/2018
Last updated
04/25/2018
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