Individual
SCOTT IRVING LAWLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, QMHP
Contact information
Practice address
847 NE 19TH AVE, PORTLAND, OR 97232-2684
(503) 238-0769
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
(503) 552-6208
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
10/14/2010
Last updated
10/27/2010
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