Individual
LAWRENCE OSEREME OMONUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MENTAL HEALTH
Contact information
Practice address
2435 GREENWAY DR NE, SALEM, OR 97301-4535
(503) 362-5918
Mailing address
5495 MCLEOD LN NE APT 104, KEIZER, OR 97303-2341
(541) 420-5773
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OR
Other
Enumeration date
09/25/2020
Last updated
09/25/2020
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