OrganizationActive
Willamette Dental
NPI 1194143065 · Health Maintenance Organization · Beaverton, OR
Provider details
- NPI number
- 1194143065
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Manimone Phanthamath, Dental Hygienist(503) 715-7876
- License
- H5456 (OR)
Specialties & taxonomies
Managed Care Organizations
Practice location
4925 Sw Griffith Dr
Beaverton, OR 97005-2923
Phone: (855) 433-6825
Approximate (ZIP-level) locationGet directions
Mailing address
1333 Se 194th Pl
Camas, WA 98607-8664
Registry dates
- Enumerated
- 2014-03-28
- Last updated
- 2014-03-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.