MEDICARE: MRS. ANDREA LORA LEHMAN BS

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
1	104100000X	Social Worker
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1427351105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANDREA LORA LEHMAN BS

Provider Business Mailing Address
First Line	:	2415 SE 43RD AVE
Second Line	:	2415 SE 43RD AVE
City	:	PORTLAND
State	:	OR
Zip	:	97206-1600
Country	:	US
Telephone Number	:	503-963-2575
Fax Number	:

Provider Business Practice Location Address
First Line	:	4212 SE DIVISION ST STE 100
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97206-1628
Country	:	US
Telephone Number	:	503-963-2575
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2010
Last Update Date	:	08/25/2015

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