Provider Demographics
NPI:1952500712
Name:LEWIS, PAUL RANDALL (PAUL LEWIS)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:RANDALL
Last Name:LEWIS
Suffix:
Gender:M
Credentials:PAUL LEWIS
Other - Prefix:MR
Other - First Name:PAUL
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PAUL LEWIS MA MFT
Mailing Address - Street 1:520 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:FRIDAY HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98250-8057
Mailing Address - Country:US
Mailing Address - Phone:360-378-2669
Mailing Address - Fax:
Practice Address - Street 1:520 SPRING ST
Practice Address - Street 2:
Practice Address - City:FRIDAY HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98250-8057
Practice Address - Country:US
Practice Address - Phone:360-378-2669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist