Individual
DR. JOHN ROBERT LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4331 NE FREMONT STREET, PORTLAND, OR 97213
(503) 331-3937
Mailing address
3731 NE 23RD AVE, PORTLAND, OR 97212-1447
(503) 475-6146
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2852 ATI
OR
152W00000X
Optometrist
OD 3706
WA
Other
Enumeration date
06/26/2006
Last updated
07/08/2007
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