Individual
LYUDMILA N AVANESOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
310 NW FLANDERS ST, PORTLAND, OR 97209-3941
(503) 827-3949
(503) 827-0931
Mailing address
14711 SW BEARD RD, APT 101, BEAVERTON, OR 97007-9120
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/24/2007
Last updated
07/08/2007
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