Individual
LORI BELLE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
627 NE EVANS ST, MCMINNVILLE, OR 97128-3923
(503) 434-7523
Mailing address
627 NE EVANS ST, MCMINNVILLE, OR 97128-3923
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
113527
OR
Other
Enumeration date
11/02/2021
Last updated
04/01/2025
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