Individual
JOSHUA DAVID LICHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 MAIN ST, KLAMATH FALLS, OR 97601-5810
(541) 238-2289
Mailing address
4000 ROUND LAKE RD SPC 25, KLAMATH FALLS, OR 97601-9069
(928) 533-0667
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000111130
OR
Other
Enumeration date
09/15/2022
Last updated
05/20/2024
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