Mikkelson, Audrey Michelle

Mikkelson, Audrey Michelle is an individual health care provider with primary practice located at 5415 Sw Westgate Dr Ste 207 , Portland OR 97221-2429. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Mikkelson, Audrey Michelle can be contacted via phone (503) 292-9274.

Contact Information

Primary practice address
5415 Sw Westgate Dr Ste 207 Portland OR 97221-2429
Phone: (503) 292-9274
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X DE61168847 Washington
Dental Providers / Pediatric Dentistry 1223P0221X D10484 Oregon

Profile Details

NPI number 1912394578
LBN Legal business name Mikkelson, Audrey Michelle
Credentials DMD, MSD
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2015
Last updated Nov 5th, 2024 - about 2 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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