Healthcare Provider Details

I. General information

NPI: 1942232533
Provider Name (Legal Business Name): BETH DIANE FINNSON RDH MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 CHEMAWA RD NE CHEMAWA INDIAN HEALTH CENTER
SALEM OR
97305-1111
US

IV. Provider business mailing address

3750 CHEMAWA RD NE
SALEM OR
97305-1111
US

V. Phone/Fax

Practice location:
  • Phone: 503-304-7600
  • Fax: 503-304-7677
Mailing address:
  • Phone: 503-304-7631
  • Fax: 503-304-7677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH2811
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: