Provider Demographics
NPI:1790933497
Name:KAO-YOUNG, CARA L (RDH, BSDH LAP)
Entity Type:Individual
Prefix:MS
First Name:CARA
Middle Name:L
Last Name:KAO-YOUNG
Suffix:
Gender:F
Credentials:RDH, BSDH LAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12000 SW 49TH AVE
Mailing Address - Street 2:PORTLAND COMMUNITY COLLEGE
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219
Mailing Address - Country:US
Mailing Address - Phone:971-722-4037
Mailing Address - Fax:
Practice Address - Street 1:12000 SW 49TH AVE
Practice Address - Street 2:PORTLAND COMMUNITY COLLEGE DENTAL HYGIENE CLINIC
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219
Practice Address - Country:US
Practice Address - Phone:971-722-4037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH2822124Q00000X
WADH 00006022124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist