Individual
INGRID M LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7110 SW FIR LOOP STE 160, TIGARD, OR 97223-8031
(971) 701-0957
Mailing address
4275 COMMERCIAL ST SE STE 180, SALEM, OR 97302-4087
(971) 701-0957
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/14/2021
Last updated
04/14/2021
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