Individual
IAN ANDERL LILLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
51 SW LEE ST, NEWPORT, OR 97365-3823
(541) 574-5960
Mailing address
36 SW NYE ST, NEWPORT, OR 97365-3821
(541) 265-0445
(844) 760-0526
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/01/2021
Last updated
04/01/2021
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