Individual
KATIE M MULLENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
426 SW STARK ST, 9TH FLOOR, PORTLAND, OR 97204-2347
(503) 988-3663
Mailing address
1735 NE AINSWORTH ST, PORTLAND, OR 97211-4966
(309) 737-0818
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
10814-16
WI
124Q00000X
Dental Hygienist
Primary
H5961
OR
Other
Enumeration date
07/28/2010
Last updated
11/19/2012
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