Provider Demographics
NPI:1912921552
Name:VIERU, FIVIA
Entity Type:Individual
Prefix:
First Name:FIVIA
Middle Name:
Last Name:VIERU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 NW TOWLE TER
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-3656
Mailing Address - Country:US
Mailing Address - Phone:503-667-5245
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:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH2937124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist