Provider Demographics
NPI:1346921228
Name:MONTEZ, LAWRENCE (CRM)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:MONTEZ
Suffix:
Gender:M
Credentials:CRM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 882
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-0882
Mailing Address - Country:US
Mailing Address - Phone:541-663-4104
Mailing Address - Fax:541-429-8822
Practice Address - Street 1:200 SE HAILEY AVE STE 105
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-3072
Practice Address - Country:US
Practice Address - Phone:541-663-4104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR23-CRM-1667175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist