Provider Demographics
NPI:1699978981
Name:MEYER, LANCE WESLEY
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:WESLEY
Last Name:MEYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2808 SE BALFOUR ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-6426
Mailing Address - Country:US
Mailing Address - Phone:503-781-9942
Mailing Address - Fax:
Practice Address - Street 1:2808 SE BALFOUR ST
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-6426
Practice Address - Country:US
Practice Address - Phone:503-659-2575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health