Individual
COREY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4373
Mailing address
210 E ECONOMY RD, MORRISTOWN, TN 37814-3756
(423) 307-1468
(423) 307-1479
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA.0006653
CO
363A00000X
Physician Assistant
PA2126
TN
363AS0400X
Surgical Physician Assistant
Primary
PA218898
OR
Other
Enumeration date
04/20/2012
Last updated
06/17/2025
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