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Individual

PETER LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
EMT

Contact information

Practice address
021 SW BANCROFT ST, PORTLAND, OR 97239-4064
(503) 975-8552
Mailing address
PO BOX 3501, PORTLAND, OR 97208-3501
(503) 975-8552

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
122578
OR

Other

Enumeration date
07/15/2020
Last updated
07/15/2020
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