Provider Demographics
NPI:1740561737
Name:NEUMEISTER, CARLEIGH ELIZABETH RAY (RDH)
Entity Type:Individual
Prefix:MRS
First Name:CARLEIGH
Middle Name:ELIZABETH RAY
Last Name:NEUMEISTER
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 1:410 NE 181ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-6666
Mailing Address - Country:US
Mailing Address - Phone:503-618-8367
Mailing Address - Fax:503-492-2545
Practice Address - Street 1:410 NE 181ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-6666
Practice Address - Country:US
Practice Address - Phone:503-618-8367
Practice Address - Fax:503-492-2545
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH6107124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist