Provider Demographics
NPI:1508400805
Name:MEAS, JOANNA MICHELLE (BSDH)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:MICHELLE
Last Name:MEAS
Suffix:
Gender:F
Credentials:BSDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5130 COPPER CREEK LOOP NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-2371
Mailing Address - Country:US
Mailing Address - Phone:503-999-0310
Mailing Address - Fax:
Practice Address - Street 1:3545 LANCASTER DR NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1435
Practice Address - Country:US
Practice Address - Phone:503-371-9897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH7529124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist