Most Relevant Information
Provider Data
  | NPI Number: | 1003558206 | 
| Provider Name: | ALEXA M LYON MD | 
| Entity Type: | Individual | 
| Taxonomy Code: | 390200000X | 
| Specialty: | Student in an Organized Health Care Education/Training Program | 
| License Number: | 
Most Important Dates
  | Enumeration Date: | 04/08/2022 | 
| Last Updated: | 04/08/2022 | 
Provider Practice Location
  3181 SW SAM JACKSON PARK RD
      
      PORTLAND
      OR
      972393011
  Practice Location Phone/Fax
      | Phone: | 5034948311 | 
| Fax: | 
Provider Mailing Location
  3181 SW SAM JACKSON PARK RD
      
      PORTLAND
      OR
      972393011
  Provider Mailing Phone/Fax
      | Phone: | 5034948211 | 
| Fax: |