Provider Demographics
NPI:1396072658
Name:JAUSSI, LAURA GRIFFITHS (RDH)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:GRIFFITHS
Last Name:JAUSSI
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 1:17630 SW CEDARVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-8699
Mailing Address - Country:US
Mailing Address - Phone:503-625-8004
Mailing Address - Fax:
Practice Address - Street 1:7145 SW VARNS ST STE 102
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8170
Practice Address - Country:US
Practice Address - Phone:503-670-7260
Practice Address - Fax:503-670-7360
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH3878124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist