Provider Demographics
NPI:1982789848
Name:ADARVE, RANIER M (DMD)
Entity Type:Individual
Prefix:
First Name:RANIER
Middle Name:M
Last Name:ADARVE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18261 SW SMOKETTE LN
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97006-3359
Mailing Address - Country:US
Mailing Address - Phone:503-591-0315
Mailing Address - Fax:
Practice Address - Street 1:611 SW CAMPUS DR
Practice Address - Street 2:ROOM 19
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3001
Practice Address - Country:US
Practice Address - Phone:503-494-4316
Practice Address - Fax:503-494-8384
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDF0019122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist