Individual
DEVIN ALEX LISDERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
422 NE 5TH ST, MCMINNVILLE, OR 97128-4604
(503) 472-4020
Mailing address
422 NE 5TH ST, MCMINNVILLE, OR 97128-4604
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/16/2018
Last updated
10/16/2018
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