OrganizationActive
Ken W. Waddell, DMD P.C.
NPI 1356530422 · General Practice Dentistry · Portland, OR
Provider details
- NPI number
- 1356530422
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Ken Waddell, Owner(503) 684-8445
- License
- D5796 (OR)
Specialties & taxonomies
Dental Providers
Practice location
15495 Sw Sequoia Pkwy
Suite 120
Portland, OR 97224-6100
Phone: (503) 684-8445
Approximate (ZIP-level) locationGet directions
Mailing address
15495 Sw Sequoia Pkwy
Portland, OR 97224-6100
Other names (DBA / former)
- Doing business as
- Dental Professional
Registry dates
- Enumerated
- 2007-10-15
- Last updated
- 2007-10-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.