Individual
LAUREN RIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
209 SW 4TH AVE, PORTLAND, OR 97204-1813
(503) 988-5464
Mailing address
209 SW 4TH AVE, PORTLAND, OR 97204-1813
(503) 988-5464
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000003658
OR
Other
Enumeration date
09/09/2024
Last updated
09/09/2024
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