Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | MD07104 | OR |
NPI | 1932424868 |
---|---|
Provider Name | Dr. Everett W Lovrien |
First Address | Fairview, OR 97024-8774 |
Second Address | Fairview, OR 97024-8774 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2010 |
Last Update Date | 04/04/2010 |