Individual
SUE A LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
17704 JEAN WAY, STE 105, LAKE OSWEGO, OR 97035-5497
(503) 675-6776
(503) 675-2372
Mailing address
17704 JEAN WAY, STE 105, LAKE OSWEGO, OR 97035-5497
(503) 675-6776
(503) 675-2372
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD19554
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
077128
—
OR
01
—
831437000
BCBS
OR
Enumeration date
08/24/2006
Last updated
06/30/2010
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