Provider Demographics
NPI:1225238587
Name:HAN, CAITLIN C (DMD)
Entity Type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:C
Last Name:HAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14201 NE 20TH AVE STE 2204
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-6413
Mailing Address - Country:US
Mailing Address - Phone:360-571-8181
Mailing Address - Fax:360-573-4022
Practice Address - Street 1:12750 SE STARK ST
Practice Address - Street 2:SUITE E
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233
Practice Address - Country:US
Practice Address - Phone:503-255-2710
Practice Address - Fax:503-255-9965
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD8962122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist