Provider Demographics
NPI:1699310946
Name:ALVAREZ, BEATRIZ (EPDH)
Entity type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:EPDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3745 PORTLAND RD NE STE 190
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-0311
Mailing Address - Country:US
Mailing Address - Phone:971-718-5477
Mailing Address - Fax:
Practice Address - Street 1:3745 PORTLAND RD NE STE 190
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-0311
Practice Address - Country:US
Practice Address - Phone:971-718-5477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH5918124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist