Individual
TERESA MARIE LUNDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
22400 SE STARK ST, GRESHAM, OR 97030-2656
(503) 674-7077
Mailing address
6305 N MONTANA AVE, PORTLAND, OR 97217-4851
(503) 201-4298
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6654
OR
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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