Individual
DAVID JOSEPH LILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
685 NW MELINDA AVE, PORTLAND, OR 97210-3126
(503) 224-8073
Mailing address
685 NW MELINDA AVE, PORTLAND, OR 97210-3126
(503) 224-8073
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
20574
OR
Other
Enumeration date
07/14/2008
Last updated
07/14/2008
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