Provider Demographics
NPI:1780829523
Name:MCKEE, RENEE' RALSTON (RDH)
Entity type:Individual
Prefix:MRS
First Name:RENEE'
Middle Name:RALSTON
Last Name:MCKEE
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:PO BOX 602
Mailing Address - Street 2:
Mailing Address - City:MOLALLA
Mailing Address - State:OR
Mailing Address - Zip Code:97038-0602
Mailing Address - Country:US
Mailing Address - Phone:503-829-6346
Mailing Address - Fax:
Practice Address - Street 1:6751 SE THIESSEN RD
Practice Address - Street 2:SUITE A
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-1800
Practice Address - Country:US
Practice Address - Phone:503-786-7792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH3037124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist