Champion, Laurissa Marie
Champion, Laurissa Marie is an individual health care provider with primary practice located at 2115 Ne 42Nd Ave , Portland OR 97213-1321. She recently has only one registered license in Dental Providers / Periodontics, which is considered as her primary health care specialty. Champion, Laurissa Marie can be contacted via phone (503) 954-1372.Contact Information
Primary practice address
2115 Ne 42Nd Ave
Portland OR 97213-1321
Phone: (503) 954-1372
Fax: (503) 954-1392
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Periodontics | 1223P0300X | D8555 | Oregon |
Profile Details
| NPI number | 1568559003 |
|---|---|
| LBN Legal business name | Champion, Laurissa Marie |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 6th, 2006 |
| Last updated | Sep 15th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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