Individual
MAXWELL LYMAN COLMENARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7511 SE HENRY ST, PORTLAND, OR 97206-6445
(503) 771-6061
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/30/2023
Last updated
06/30/2023
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