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General NPI Number Information
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NPI Number | 1477220291
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Entity Type | Individual
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Provider Name | ERIC DANIEL CHRISTENSEN DMD
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Gender | Male
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Dates
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Enumeration Date | 08/28/2021
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Last Update Date | 08/28/2021
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Provider Practice Location Address
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Address Line | 2905 SW CEDAR HILLS BLVD
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City | BEAVERTON
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State | OR
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Zip | 97005-1470
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Country | US
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Telephone | 150-339-6407
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Fax |
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Provider Business Mailing Address
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Address Line | 4940 SW DOGWOOD LN
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City | PORTLAND
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State | OR
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Zip | 97225-1414
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Country | US
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Telephone | 209-969-4900
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D11526
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License Number State | OR
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