Provider Demographics
NPI:1194972687
Name:WELIKY, KAREN (DMD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:WELIKY
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 1:2636 SE HARRISON ST
Mailing Address - Street 2:#B
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-7587
Mailing Address - Country:US
Mailing Address - Phone:503-659-9658
Mailing Address - Fax:503-513-9597
Practice Address - Street 1:2636 SE HARRISON ST
Practice Address - Street 2:#B
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-7587
Practice Address - Country:US
Practice Address - Phone:503-659-9658
Practice Address - Fax:503-513-9597
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD6711122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist