Basic Information
Provider Information
NPI: 1073718276
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOMBARDI
FirstName: LORINNA
MiddleName: H
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 22009
Address2:  
City: PORTLAND
State: OR
PostalCode: 972692009
CountryCode: US
TelephoneNumber: 4025587372
FaxNumber:  
Practice Location
Address1: 19250 SW 65TH AVE STE 215
Address2:  
City: TUALATIN
State: OR
PostalCode: 970627707
CountryCode: US
TelephoneNumber: 5036923630
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/18/2007
LastUpdateDate: 01/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207W00000X16463ORY Allopathic & Osteopathic PhysiciansOphthalmology 

No ID Information.


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