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Individual

KAYLE 'SPIKE' SANDBERG-LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT, MA

Contact information

Practice address
1433 SE TOLMAN ST, PORTLAND, OR 97202-5421
(503) 234-2733
Mailing address
6336 SE MILWAUKIE AVE, #8, PORTLAND, OR 97202-5474
(503) 234-2733

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
09/25/2007
Last updated
09/25/2007
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