Provider Demographics
NPI:1386378040
Name:YODER, JENNIFER ANNELL (RDH)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANNELL
Last Name:YODER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ANNELL
Other - Last Name:ABEGGLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:41919 NW LYONS RD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98674-3025
Mailing Address - Country:US
Mailing Address - Phone:360-798-6478
Mailing Address - Fax:
Practice Address - Street 1:41919 NW LYONS RD
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:WA
Practice Address - Zip Code:98674-3025
Practice Address - Country:US
Practice Address - Phone:360-798-6478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-10
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist