NPI 1013066976

Jean Rae Custer, RDH

Practitioner Dental Hygienist Portland, OR

Practice location

Address: 10317 E Burnside St 2nd Floor, Portland, OR 97216-2733
Phone: (503) 988-3905
Mailing address: 710 SW 6th CT, Portland, OR 97219-6562

Registered specialties

Dental Hygienist Primary

Dental Providers Taxonomy 124Q00000X Licence 1255 (OR)

Other Dental Hygienist providers in Oregon →

Registry record

NPI: 1013066976
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 Jan 2007
Record last updated: 8 Jul 2007

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.