Individual
LYDIA LORRAINE WEEKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
15351 SE 82ND DR, CLACKAMAS, OR 97015-9667
(971) 400-5965
Mailing address
3605 SE 166TH PL, PORTLAND, OR 97236-1521
(971) 400-5965
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20114
OR
Other
Enumeration date
09/26/2013
Last updated
09/26/2013
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