Individual
JODY LYNN WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
4095 SW 144TH AVE, BEAVERTON, OR 97005-2368
(503) 643-4719
Mailing address
4095 SW 144TH AVE, BEAVERTON, OR 97005-2368
(503) 643-4719
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H 5251
OR
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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