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General NPI Number Information
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NPI Number | 1487918793
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Entity Type | Individual
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Provider Name | KRISTA LOWEN DDS, MSD
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Gender | Female
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Dates
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Enumeration Date | 07/02/2012
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 9900 SW GREENBURG RD STE 230
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City | TIGARD
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State | OR
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Zip | 97223-5473
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Country | US
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Telephone | 503-620-1117
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Fax |
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Provider Business Mailing Address
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Address Line | 2943 NE 29TH AVE
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City | PORTLAND
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State | OR
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Zip | 97212-3558
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Country | US
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Telephone | 971-645-5241
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DE60100282
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | D9794
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License Number State | OR
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