Individual
HAVEN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6400 SE LAKE RD STE 250, MILWAUKIE, OR 97222-2129
(541) 900-4285
Mailing address
4986 SE LINCOLN ST, PORTLAND, OR 97215-3843
(609) 706-2761
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
R8987
OR
Other
Enumeration date
05/10/2024
Last updated
05/10/2024
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