Provider Demographics
NPI:1669998977
Name:DUEY, MEGHAN KATHLEEN TOEVS (RDH)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:KATHLEEN TOEVS
Last Name:DUEY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:KATHLEEN
Other - Last Name:TOEVS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:4700 SE GLADSTONE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-3276
Mailing Address - Country:US
Mailing Address - Phone:971-409-6822
Mailing Address - Fax:
Practice Address - Street 1:5025 SE 28TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-4445
Practice Address - Country:US
Practice Address - Phone:503-286-6868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH3984124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist