Provider Demographics
NPI:1669952834
Name:WRIGHT, ANGELA (EFDA)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:EFDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 SE HAMPTON LOOP
Mailing Address - Street 2:
Mailing Address - City:TROUTDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97060-8618
Mailing Address - Country:US
Mailing Address - Phone:503-490-7071
Mailing Address - Fax:
Practice Address - Street 1:822 NE 181ST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-6708
Practice Address - Country:US
Practice Address - Phone:503-661-5210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant