Vivian Lackey

NPI 1063818995 - Case Manager/Care Coordinator - 171M00000X

NPI Details
NPI 1063818995
Gender Female
Enumeration Date 11/04/2014
Last Updated 11/04/2014
Entity Type Individual
Active Over 2 years ago
Practice Location
2 NW 2ND AVE
PORTLAND OR, 97209-3902, US
Phone (503) 226-7387
Fax
Business Location
2 NW 2ND AVE
PORTLAND OR, 97209-3902, US
Phone (503) 226-7387
Fax (503) 226-7921
Toxanomy
Taxonomy Code 171M00000X
License State
License Number
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According to our database, Vivian Lackey NPI is 1063818995, taxonomy code is 171M00000X Vivian Lackey physically located at 2 Nw 2nd Ave, Portland OR, 97209-3902. NPI Number Vivian Lackey has the Individual type.

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1063818995 NPI number is provided on an as is basis without warranty of any kind. 1063818995 is maintained by the National Plan & Provider Enumeration System. The contents of Vivian Lackey are for informational purposes only.