Provider Demographics
NPI:1700530243
Name:ALLBRIGHT, JENNIFER P (RDH)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:P
Last Name:ALLBRIGHT
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:P
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:PO BOX 489
Mailing Address - Street 2:
Mailing Address - City:TILLAMOOK
Mailing Address - State:OR
Mailing Address - Zip Code:97141-0489
Mailing Address - Country:US
Mailing Address - Phone:503-842-3929
Mailing Address - Fax:503-842-6099
Practice Address - Street 1:805 IVY AVE STE B
Practice Address - Street 2:
Practice Address - City:TILLAMOOK
Practice Address - State:OR
Practice Address - Zip Code:97141-3758
Practice Address - Country:US
Practice Address - Phone:503-842-3929
Practice Address - Fax:503-842-6099
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1417568668Medicaid