Provider Demographics
NPI:1720760416
Name:YAHN, MARGARET MACKENZIE (DMD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MACKENZIE
Last Name:YAHN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12205 SW SUMMER CREST DR
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-3244
Mailing Address - Country:US
Mailing Address - Phone:503-810-2159
Mailing Address - Fax:
Practice Address - Street 1:1710 SW 9TH AVE STE 120
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-3267
Practice Address - Country:US
Practice Address - Phone:360-474-4371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD11864122300000X
WADE61479749122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty