Provider Demographics
NPI:1184467524
Name:TESTORI-SOBOLEWSKI, LISA
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:TESTORI-SOBOLEWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14217 NW 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-1704
Mailing Address - Country:US
Mailing Address - Phone:360-606-1993
Mailing Address - Fax:
Practice Address - Street 1:9930 N SMITH ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-1552
Practice Address - Country:US
Practice Address - Phone:503-916-6277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics