Provider Demographics
NPI:1154181147
Name:VALLE LOPEZ, CESAR ORLANDO (CRM CGRM)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:ORLANDO
Last Name:VALLE LOPEZ
Suffix:
Gender:M
Credentials:CRM CGRM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10564 SE WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2809
Mailing Address - Country:US
Mailing Address - Phone:971-442-5682
Mailing Address - Fax:
Practice Address - Street 1:10564 SE WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2809
Practice Address - Country:US
Practice Address - Phone:971-442-5682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR23-CRM-2287175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist