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1063818995
VIVIAN LACKEY
PORTLAND, OR
NPI
1063818995
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2014-11-04
Last Update Date
2014-11-04
Business Address
-- VIVIAN LACKEY
2 NW 2ND AVE
PORTLAND, OR 97209-3902
Phone number: 503-226-7387
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Mailing Address
-- VIVIAN LACKEY
2 NW 2ND AVE
PORTLAND, OR 97209-3902
Phone number: 503-226-7387
Copy
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