Individual
LIZZET DEL CARMEN CERVANTES PANTOJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14025 SW FARMINGTON RD STE 160, BEAVERTON, OR 97005-2512
(503) 258-4495
Mailing address
11035 NE SANDY BLVD, PORTLAND, OR 97220-2553
(503) 258-4200
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/27/2019
Last updated
11/29/2019
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