Healthcare Provider Details

I. General information

NPI: 1972784304
Provider Name (Legal Business Name): DOYLE CRAMPTON RDH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5935 SE ALEXANDER ST
HILLSBORO OR
97123-8575
US

IV. Provider business mailing address

5935 SE ALEXANDER ST
HILLSBORO OR
97123-8575
US

V. Phone/Fax

Practice location:
  • Phone: 503-644-6444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH3908
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: