Provider Demographics
NPI:1801209622
Name:HOUSER, CRIS
Entity Type:Individual
Prefix:
First Name:CRIS
Middle Name:
Last Name:HOUSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:759 FAIR OAKS DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2392
Mailing Address - Country:US
Mailing Address - Phone:541-484-0974
Mailing Address - Fax:
Practice Address - Street 1:759 FAIR OAKS DR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2392
Practice Address - Country:US
Practice Address - Phone:541-484-0974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH2727124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist