Provider Demographics
NPI:1194938654
Name:SOLUM, LUANE JEANETTE (LMT,LMP)
Entity type:Individual
Prefix:MRS
First Name:LUANE
Middle Name:JEANETTE
Last Name:SOLUM
Suffix:
Gender:F
Credentials:LMT,LMP
Other - Prefix:MRS
Other - First Name:L
Other - Middle Name:JEANETTE
Other - Last Name:SOLUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT,LMP
Mailing Address - Street 1:1654 TUCKER RD
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-9681
Mailing Address - Country:US
Mailing Address - Phone:541-716-4826
Mailing Address - Fax:
Practice Address - Street 1:1942 12TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-9542
Practice Address - Country:US
Practice Address - Phone:541-490-6154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11258174400000X
WAMA00020451174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist