Individual
AUTUMN LILLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 231-1654
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 231-1654
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/02/2015
Last updated
06/02/2015
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