Costello, Chanda J
Costello, Chanda J is an individual health care provider with primary practice located at 10211 Sw Park Way , Portland OR 97225-5009. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Costello, Chanda J can be contacted via phone (503) 203-6978.Contact Information
Primary practice address
10211 Sw Park Way
Portland OR 97225-5009
Phone: (503) 203-6978
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D9133 | Oregon |
Profile Details
| NPI number | 1235385980 |
|---|---|
| LBN Legal business name | Costello, Chanda J |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 13th, 2008 |
| Last updated | Mar 5th, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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