Individual
TENNESON L LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1431 NE 21ST AVE APT 107, PORTLAND, OR 97232-1547
(406) 880-4239
Mailing address
1431 NE 21ST AVE APT 107, PORTLAND, OR 97232-1547
(406) 880-4239
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200930432LPN
OR
Other
Enumeration date
10/14/2009
Last updated
10/14/2009
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