NPI 1043857105

Reagan Ravanzo Blanco

Practitioner Dental Assistant Beaverton, OR

Practice location

Address: 4855 SW Western Ave, Beaverton, OR 97005-3460
Phone: (503) 813-2000
Mailing address: 1771 SE Dowery Ln, Hillsboro, OR 97123-5090

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X Licence 122012 (OR)

Other Dental Assistant providers in Oregon →

Registry record

NPI: 1043857105
Entity type: Individual
Sex (as registered): Female
NPI issued: 6 Dec 2019
Record last updated: 6 Dec 2019

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.