Individual
JENNIFER L LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1320 NE 106TH AVE, PORTLAND, OR 97220-3966
(503) 908-2020
Mailing address
1320 NE 106TH AVE, PORTLAND, OR 97220-3966
(503) 908-2020
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD18424
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078944
—
OR
01
—
180025900
RAILROAD MEDICARE
OR
Enumeration date
11/03/2005
Last updated
02/10/2021
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