Individual
SANDRA LEE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
10209 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9782
(506) 353-3900
(503) 353-3903
Mailing address
PO BOX 835, SILVERTON, OR 97381-0835
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H1769
OR
Other
Enumeration date
08/28/2006
Last updated
03/08/2022
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