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1114394079
ANTHONY MICHAEL LOPEZ
PORTLAND, OR
NPI
1114394079
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
(Licence: OR 21295)
Enumeration Date
2015-08-27
Last Update Date
2016-08-24
Business Address
-- ANTHONY MICHAEL LOPEZ LMT
6504 NE SISKIYOU ST
PORTLAND, OR 97213-4572
Phone number: 901-409-1352
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Mailing Address
-- ANTHONY MICHAEL LOPEZ LMT
1307 SE 17TH AVE
PORTLAND, OR 97214-3797
Phone number: 503-310-3087
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