Individual
LAUREN D MUSSELWHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1256 SE OLVERA PL, GRESHAM, OR 97080-9133
(503) 804-7989
Mailing address
1256 SE OLVERA PL, GRESHAM, OR 97080-9133
(503) 573-8290
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
25-QMHA-R-7663
OR
Other
Enumeration date
10/01/2025
Last updated
10/01/2025
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