Provider Demographics
NPI:1083997696
Name:LORA, GRECIA ARIANA (BSW)
Entity Type:Individual
Prefix:
First Name:GRECIA
Middle Name:ARIANA
Last Name:LORA
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5529 NE 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-4942
Mailing Address - Country:US
Mailing Address - Phone:541-490-2905
Mailing Address - Fax:
Practice Address - Street 1:5529 NE 16TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-4942
Practice Address - Country:US
Practice Address - Phone:541-490-2905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator