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General NPI Number Information
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NPI Number | 1124363395
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Entity Type | Individual
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Provider Name | ANNA A DOROSHENKO RDH
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Gender | Female
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Dates
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Enumeration Date | 11/29/2012
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Last Update Date | 05/11/2018
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Provider Practice Location Address
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Address Line | 19000 NW EVERGREEN PKWY APT 65
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City | HILLSBORO
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State | OR
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Zip | 97124-7007
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Country | US
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Telephone | 971-340-9487
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Fax |
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Provider Business Mailing Address
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Address Line | 14410 SE BUSH ST
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City | PORTLAND
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State | OR
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Zip | 97236-2539
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Country | US
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Telephone | 971-340-9487
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | H6250
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License Number State | OR
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