Provider Demographics
NPI:1548414030
Name:ABRIEL, RADAWN LEE (RDH)
Entity Type:Individual
Prefix:MISS
First Name:RADAWN
Middle Name:LEE
Last Name:ABRIEL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2992 NW OVERLOOK DR
Mailing Address - Street 2:APT 1913
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-6951
Mailing Address - Country:US
Mailing Address - Phone:503-866-8014
Mailing Address - Fax:
Practice Address - Street 1:2471 NW 185TH AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-7077
Practice Address - Country:US
Practice Address - Phone:503-690-9536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH5467124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist