Healthcare Provider Details

I. General information

NPI: 1326322603
Provider Name (Legal Business Name): ALYNN VIENOT HAYES RDH, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2011
Last Update Date: 10/12/2021
Certification Date: 10/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19029 BEAVERCREEK RD
OREGON CITY OR
97045-9537
US

IV. Provider business mailing address

7320 SW HUNZIKER RD STE 300
TIGARD OR
97223-2302
US

V. Phone/Fax

Practice location:
  • Phone: 503-941-3064
  • Fax:
Mailing address:
  • Phone: 503-567-2550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number905263
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH5701
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: