Individual
TRACY LEWIS LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5511 SE HAWTHORNE BLVD, PORTLAND, OR 97215-3367
(503) 517-1895
Mailing address
5511 SE HAWTHORNE BLVD, PORTLAND, OR 97215-3367
(503) 517-1895
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C4407
OR
Other
Enumeration date
04/19/2017
Last updated
04/19/2017
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