Provider Demographics
NPI:1568509115
Name:LOWE, KATHY S (RDH)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:S
Last Name:LOWE
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:PO BOX 170
Mailing Address - Street 2:
Mailing Address - City:CORBETT
Mailing Address - State:OR
Mailing Address - Zip Code:97019-0170
Mailing Address - Country:US
Mailing Address - Phone:503-253-0426
Mailing Address - Fax:
Practice Address - Street 1:10317 E BURNSIDE ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2733
Practice Address - Country:US
Practice Address - Phone:503-988-3905
Practice Address - Fax:503-988-6240
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH1206124Q00000X
CA7614124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist