NPI 1093646085
Waggoner Dentistry PC
Practice location
- Address
- 15962 Boones Ferry Rd STE 208, Lake Oswego, OR 97035-4360
- Phone
- (503) 292-9274
- Mailing address
- 5415 SW Westgate Dr STE 207, Portland, OR 97221-2429
Authorised official
- Name
- Tesha Waggoner
- Title
- Owner
- Phone
- (503) 292-9274
Registered specialties
Pediatric Dentistry
Primary
Registry record
- NPI
- 1093646085
- Entity type
- Organization
- NPI issued
- 27 May 2026
- Record last updated
- 27 May 2026
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.