Healthcare Provider Details
I. General information
NPI: 1225019110
Provider Name (Legal Business Name): DREW D LEWIS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/08/2005
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2200 NE NEFF RD STE 200
BEND OR
97701-4281
US
IV. Provider business mailing address
PO BOX 1462
HUGHSON CA
95326-1462
US
V. Phone/Fax
- Phone: 541-382-3344
- Fax: 541-382-1681
- Phone: 515-271-1722
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | 3832 |
| License Number State | IA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2081P2900X |
| Taxonomy | Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | 21540 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: