Individual
STEPHEN LYDDANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2073 OLYMPIC ST, SPRINGFIELD, OR 97477-3413
(541) 682-3550
(541) 682-3551
Mailing address
2073 OLYMPIC ST, SPRINGFIELD, OR 97477-3413
(541) 682-3550
(541) 682-3551
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201608698RN
OR
163W00000X
Registered Nurse
NURR38019
AK
Other
Enumeration date
04/10/2015
Last updated
02/01/2017
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