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NPI Code Detail

MEDICARE: LYN ANN DELMASTRO M.A., R.Y.T.

MEDICARE: LYN ANN DELMASTRO M.A., R.Y.T.
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1942554613
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYN ANN DELMASTRO M.A., R.Y.T.
Provider Business Mailing Address
First Line : 5525 E BURNSIDE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97215-1258
Country : US
Telephone Number : 503-347-0258
Fax Number :
Provider Business Practice Location Address
First Line : 5525 E BURNSIDE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97215-1258
Country : US
Telephone Number : 503-347-0258
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2012
Last Update Date : 11/02/2012

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