Provider Demographics
NPI:1982988069
Name:KNOWLES, WHITNEY BRYCE MACHADO-CHING (RDH, EPDH)
Entity type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:BRYCE MACHADO-CHING
Last Name:KNOWLES
Suffix:
Gender:F
Credentials:RDH, EPDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:HEPPNER
Mailing Address - State:OR
Mailing Address - Zip Code:97836-0248
Mailing Address - Country:US
Mailing Address - Phone:541-676-9118
Mailing Address - Fax:541-676-9904
Practice Address - Street 1:143 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HEPPNER
Practice Address - State:OR
Practice Address - Zip Code:97836-5001
Practice Address - Country:US
Practice Address - Phone:541-676-9118
Practice Address - Fax:541-676-9904
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH5635124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist