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General NPI Number Information
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NPI Number | 1568501732
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Entity Type | Individual
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Provider Name | LILIA SENTCHOUK LD
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10555 SE 82ND AVE # 102
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City | HAPPY VALLEY
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State | OR
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Zip | 97266-7374
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Country | US
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Telephone | 503-358-9098
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Fax |
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Provider Business Mailing Address
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Address Line | 10555 SE 82ND AVE # 102
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City | HAPPY VALLEY
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State | OR
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Zip | 97266-7374
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Country | US
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Telephone | 503-358-9098
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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 | 122400000X
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Taxonomy Name | Denturist
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License Number | DT-DO-10115004
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License Number State | OR
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