Provider Demographics
NPI:1720134000
Name:SPITZE, RAINI (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAINI
Middle Name:
Last Name:SPITZE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 REMINGTON DR
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4165
Mailing Address - Country:US
Mailing Address - Phone:503-631-2353
Mailing Address - Fax:503-631-3253
Practice Address - Street 1:18221 S REDLAND RD
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-8823
Practice Address - Country:US
Practice Address - Phone:503-631-2353
Practice Address - Fax:503-631-3253
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD94241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice