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General NPI Number Information
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NPI Number | 1154874709
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Entity Type | Individual
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Provider Name | RACHEL E HOGAN DMD
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Gender | Female
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Dates
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Enumeration Date | 08/01/2016
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Last Update Date | 12/12/2022
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Provider Practice Location Address
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Address Line | 5000 MEADOWS RD STE 230
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-2268
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Country | US
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Telephone | 503-882-0026
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Fax | 503-908-2218
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Provider Business Mailing Address
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Address Line | 333 S STATE ST STE V-327
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City | LAKE OSWEGO
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State | OR
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Zip | 97034-3932
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Country | US
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Telephone | 503-882-0026
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | D7353
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License Number State | OR
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