Provider Demographics
NPI:1316311855
Name:LOMONTE, COURTNEY (LAC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:LOMONTE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 SE BYBEE BLVD
Mailing Address - Street 2:APT # 2
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-5751
Mailing Address - Country:US
Mailing Address - Phone:919-618-1893
Mailing Address - Fax:
Practice Address - Street 1:4200 MERCANTILE DR
Practice Address - Street 2:SUITE 750
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-3597
Practice Address - Country:US
Practice Address - Phone:503-305-7762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC174246171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist