Whitman, Anastacia M.

Whitman, Anastacia M. is an individual health care provider with primary practice located at 4548 N Albina Ave , Portland OR 97217-3010. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Whitman, Anastacia M. can be contacted via phone (503) 626-9711.

Contact Information

Primary practice address
4548 N Albina Ave Portland OR 97217-3010
Phone: (503) 626-9711
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 10970 Washington
Dental Providers / Pediatric Dentistry 1223P0221X D8950 Oregon

Profile Details

NPI number 1972639623
LBN Legal business name Whitman, Anastacia M.
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 26th, 2007
Last updated Feb 10th, 2016 - about 8 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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Identifiers

StateTypeNumberIssuer
All States NPI 1972639623 NPPES
Oregon MEDICAID 244432

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