MEDICARE: REBA RAY LUGO-SENA FULL SPECTRUM DOULA

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	374J00000X	Doula		OR

General Provider Information

NPI Number	:	1912845116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBA RAY LUGO-SENA FULL SPECTRUM DOULA

Provider Business Mailing Address
First Line	:	3431 NE FREMONT DR
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97220-5368
Country	:	US
Telephone Number	:	907-299-4418
Fax Number	:

Provider Business Practice Location Address
First Line	:	3431 NE FREMONT DR
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97220-5368
Country	:	US
Telephone Number	:	907-299-4418
Fax Number	:

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

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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