Individual
DR. LORELYNN MIRAGE CARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1221 SE MADISON ST, PORTLAND, OR 97214-3890
(503) 445-7767
Mailing address
1818 NW 156TH AVE, BEAVERTON, OR 97006-5665
(503) 690-7727
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
NY
174H00000X
Health Educator
—
—
Other
Enumeration date
09/13/2012
Last updated
07/21/2022
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