Individual
VIKTORIYA KRUGHKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13831 NW CORNELL RD, PORTLAND, OR 97229-5485
(503) 718-3762
Mailing address
907 NE 194TH AVE, PORTLAND, OR 97230-7719
(971) 303-6449
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H7551
OR
Other
Enumeration date
08/02/2018
Last updated
08/02/2018
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