Individual
MICHELLE E LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1600 STATE ST, SALEM, OR 97301-4257
(503) 540-6300
(503) 540-6404
Mailing address
1600 STATE ST, SALEM, OR 97301-4257
(503) 540-6300
(503) 540-6404
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500629175
—
OR
Enumeration date
10/22/2010
Last updated
02/13/2014
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