Provider Demographics
NPI:1083601694
Name:FOSTER, VALERIE A (DMD, PC)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:A
Last Name:FOSTER
Suffix:
Gender:F
Credentials:DMD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19560 SW ALEXANDER ST
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97006-2315
Mailing Address - Country:US
Mailing Address - Phone:503-649-7011
Mailing Address - Fax:503-642-9897
Practice Address - Street 1:19560 SW ALEXANDER ST
Practice Address - Street 2:
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97006-2315
Practice Address - Country:US
Practice Address - Phone:503-649-7011
Practice Address - Fax:503-642-9897
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD62691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice