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Individual

MR. MARC GRAYSON LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN, BSN, CARN, QMHP

Contact information

Practice address
685 SE 3RD ST, BEND, OR 97702-1754
(541) 668-9070
Mailing address
2711 NW RAINBOW RIDGE DR, BEND, OR 97703-8722
(808) 345-6027

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
22-QMHPC-001160
OR
163W00000X
Registered Nurse
Primary
201805080RN
OR

Other

Enumeration date
08/05/2020
Last updated
05/02/2025
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