Individual
MRS. LARA LEZRINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4525 NE 10TH AVE, PORTLAND, OR 97211-4567
(503) 750-3473
Mailing address
4525 NE 10TH AVE, PORTLAND, OR 97211-4567
(503) 750-3473
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
11780
OR
Other
Enumeration date
08/14/2012
Last updated
08/14/2012
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