Individual
MISS DORIS LYENTTE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
326 SE 76TH AVE, PORTLAND, OR 97215-1468
(503) 255-3198
Mailing address
5435 NE 54TH AVE, PORTLAND, OR 97218-2519
(503) 740-8689
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
02/28/2007
Last updated
10/17/2007
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