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Individual

DR. JEFFERY THOMAS LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1701 SHADOW WOOD DR, WEST LINN, OR 97068-9746
(503) 708-6866
Mailing address
1701 SHADOW WOOD DR, WEST LINN, OR 97068-9746
(503) 708-6866

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C4623
OR
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500673381
OR
Enumeration date
03/16/2015
Last updated
03/06/2026
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