Provider Demographics
NPI:1689777096
Name:HELLUMS, DONNA MARIE LEWIS (RDH)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:MARIE LEWIS
Last Name:HELLUMS
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 1:1609 NE 137TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230
Mailing Address - Country:US
Mailing Address - Phone:503-257-9421
Mailing Address - Fax:
Practice Address - Street 1:7105 SW HAMPTON ST
Practice Address - Street 2:KAISER PERMANENTE
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223
Practice Address - Country:US
Practice Address - Phone:503-684-9274
Practice Address - Fax:503-624-9210
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH1993124Q00000X
WADH00002850124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist