Provider Demographics
NPI:1437966215
Name:SHIRTZ, KARIE E (RDH)
Entity type:Individual
Prefix:MRS
First Name:KARIE
Middle Name:E
Last Name:SHIRTZ
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17655 SW HEATHERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-7105
Mailing Address - Country:US
Mailing Address - Phone:503-307-4627
Mailing Address - Fax:
Practice Address - Street 1:17655 SW HEATHERWOOD LN
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-7105
Practice Address - Country:US
Practice Address - Phone:503-307-4627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH5043124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist