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NPI Code Detail

MEDICARE: MARY KRISTINE LOPES

MEDICARE: MARY KRISTINE LOPES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1063997195
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY KRISTINE LOPES
Provider Business Mailing Address
First Line : 239 NE LINCOLN ST
Second Line :
City : HILLSBORO
State : OR
Zip : 97124-3066
Country : US
Telephone Number : 971-238-4408
Fax Number : 971-238-8061
Provider Business Practice Location Address
First Line : 239 NE LINCOLN ST
Second Line :
City : HILLSBORO
State : OR
Zip : 97124-3066
Country : US
Telephone Number : 971-238-4408
Fax Number : 971-238-8061
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2018
Last Update Date : 10/15/2024

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Directions to “ MARY KRISTINE LOPES ” Practice Location

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