Provider Demographics
NPI:1215288139
Name:STERNTHAL, PATRICIA LEWANDOWSKY (LMT)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LEWANDOWSKY
Last Name:STERNTHAL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5515 NE 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-4346
Mailing Address - Country:US
Mailing Address - Phone:503-803-8447
Mailing Address - Fax:
Practice Address - Street 1:107 SE WASHINGTON ST
Practice Address - Street 2:SUITE 125
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2103
Practice Address - Country:US
Practice Address - Phone:503-239-2639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR14512225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist