Healthcare Provider Details

I. General information

NPI: 1255391868
Provider Name (Legal Business Name): CYNTHIA RHEA LEWIS-YOUNGER MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CYNTHIA RHEA LEWIS MD, MPH

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 08/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 HILLTOP RD
WASHOUGAL WA
98671
US

IV. Provider business mailing address

121 HILLTOP RD
WASHOUGAL WA
98671-7222
US

V. Phone/Fax

Practice location:
  • Phone: 813-321-9776
  • Fax: 813-246-4654
Mailing address:
  • Phone: 813-321-9776
  • Fax: 813-246-4654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083T0002X
TaxonomyMedical Toxicology (Preventive Medicine) Physician
License NumberMD00040364
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2083T0002X
TaxonomyMedical Toxicology (Preventive Medicine) Physician
License NumberMD173259
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD173259
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD00040364
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD173259
License Number StateOR
# 6
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD00040364
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: