Individual
LISA LYNN RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
906 MAIN AVE, TILLAMOOK, OR 97141-3816
(503) 842-8201
(503) 815-1870
Mailing address
906 MAIN AVE, TILLAMOOK, OR 97141-3816
(503) 842-8201
(503) 815-1870
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000106186
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
THW000106186
TRADITIONAL HEALTHCARE WORKER - PEER SUPPORT SPECIALIST
OR
Enumeration date
02/14/2022
Last updated
02/14/2022
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