1639294945 NPI number — MRS. DEBORAH DEANNE LAMONT LMT

Table of content: MRS. DEBORAH DEANNE LAMONT LMT (NPI 1639294945)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639294945 NPI number — MRS. DEBORAH DEANNE LAMONT LMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAMONT
Provider First Name:
DEBORAH
Provider Middle Name:
DEANNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LAMONT
Provider Other First Name:
DEDE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1639294945
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21400 S SALAMO RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST LINN
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97068-7201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-650-2487
Provider Business Mailing Address Fax Number:
503-650-4382

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21400 S SALAMO RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST LINN
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97068-7201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-650-2487
Provider Business Practice Location Address Fax Number:
503-650-4382
Provider Enumeration Date:
03/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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