Provider Demographics
NPI:1154874709
Name:HOGAN, RACHEL E (DMD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:E
Last Name:HOGAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 S STATE ST STE V-327
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-3932
Mailing Address - Country:US
Mailing Address - Phone:503-882-0026
Mailing Address - Fax:
Practice Address - Street 1:5000 MEADOWS RD STE 230
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-2268
Practice Address - Country:US
Practice Address - Phone:503-882-0026
Practice Address - Fax:503-908-2218
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-01
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD7353122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist