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Individual

DR. ANASTACIA M. WHITMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
4548 N ALBINA AVE, PORTLAND, OR 97217-3010
(503) 626-9711
Mailing address
4548 N ALBINA AVE, PORTLAND, OR 97217-3010
(503) 626-9711

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
10970
WA
1223P0221X
Pediatric Dentistry
Primary
D8950
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
244432
OR
Enumeration date
02/26/2007
Last updated
02/10/2016
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