Individual
KENNETH LORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1180 NE BURNSIDE RD, GRESHAM, OR 97030-5711
(503) 669-3061
(503) 328-0020
Mailing address
1180 NE BURNSIDE RD, GRESHAM, OR 97030-5711
(503) 669-3061
(503) 328-0020
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HASP 10124821
OR
Other
Enumeration date
12/09/2014
Last updated
10/13/2015
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