Provider Demographics
NPI:1942232533
Name:FINNSON, BETH DIANE (RDH MPH)
Entity Type:Individual
Prefix:MISS
First Name:BETH
Middle Name:DIANE
Last Name:FINNSON
Suffix:
Gender:F
Credentials:RDH MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 CHEMAWA RD NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-1111
Mailing Address - Country:US
Mailing Address - Phone:503-304-7631
Mailing Address - Fax:503-304-7677
Practice Address - Street 1:3750 CHEMAWA RD NE
Practice Address - Street 2:CHEMAWA INDIAN HEALTH CENTER
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1111
Practice Address - Country:US
Practice Address - Phone:503-304-7600
Practice Address - Fax:503-304-7677
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH2811124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR278159Medicaid