Individual
LESA SHERILYN INGRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19075 NW TANASBOURNE DR STE 300, HILLSBORO, OR 97124-5802
(503) 531-1700
(503) 531-1704
Mailing address
19075 NW TANASBOURNE DR STE 300, HILLSBORO, OR 97124-5802
(503) 531-1700
(503) 531-1704
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
A10270
OR
Other
Enumeration date
09/16/2009
Last updated
09/16/2009
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