Individual
MRS. L. NICOLE LEWIS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
235 INDEPENDENCE WAY, INDEPENDENCE, OR 97351-9575
(503) 838-4244
Mailing address
235 INDEPENDENCE WAY, INDEPENDENCE, OR 97351-9575
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-954795
OR
Other
Enumeration date
04/10/2006
Last updated
07/08/2007
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