Individual
LORI BETTENCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4224 NE HALSEY ST, SUITE 325, PORTLAND, OR 97213-1538
(503) 505-6181
Mailing address
PO BOX 15031, PORTLAND, OR 97293-5031
(503) 334-7552
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
20303
OR
Other
Enumeration date
01/23/2014
Last updated
01/23/2014
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