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Individual

TANDACE DEEANN LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3600 N INTERSTATE AVE, PORTLAND, OR 97227-1106
(503) 249-3429
Mailing address
16900 NE 22ND ST, VANCOUVER, WA 98684-6700
(360) 944-6816

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary

Other

Enumeration date
10/06/2006
Last updated
07/08/2007
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