Individual
LEWIS BANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., PSYCHOLOGIST
Contact information
Practice address
1345 NW WALL ST STE 303, BEND, OR 97703-1970
(503) 367-4042
(844) 269-6806
Mailing address
1345 NW WALL ST STE 303, BEND, OR 97703-1970
(503) 367-4042
(844) 269-6806
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
605
OR
103G00000X
Clinical Neuropsychologist
605
OR
103K00000X
Behavior Analyst
605
OR
103T00000X
Psychologist
Primary
605
OR
Other
Enumeration date
08/22/2014
Last updated
09/16/2020
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