Lizelle Chandler, | |
17632 Woodhurst Pl, Lake Oswego, OR 97034-4011 | |
(408) 656-2662 | |
Not Available |
Full Name | Lizelle Chandler |
---|---|
Gender | Female |
Speciality | Occupational Therapist |
Location | 17632 Woodhurst Pl, Lake Oswego, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013319532 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | 4360 (California) | Secondary |
225X00000X | Occupational Therapist | 998155 (Oregon) | Primary |
Provider Name | Kaiser Foundation Health Plan Of The Northwest |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1184786527 PECOS PAC ID: 5799688230 Enrollment ID: O20040130000799 |
Mailing Address | Practice Location Address |
---|---|
Lizelle Chandler, 17632 Woodhurst Pl, Lake Oswego, OR 97034-4011 Ph: (408) 656-2662 | Lizelle Chandler, 17632 Woodhurst Pl, Lake Oswego, OR 97034-4011 Ph: (408) 656-2662 |
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