Provider Demographics
NPI:1538413729
Name:SYKES, LORRAINE
Entity type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:
Last Name:SYKES
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LORRAINE
Other - Middle Name:
Other - Last Name:SYKES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:4777 SW 11TH ST
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97080-4320
Mailing Address - Country:US
Mailing Address - Phone:503-481-7062
Mailing Address - Fax:
Practice Address - Street 1:4777 SW 11TH ST
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97080-4320
Practice Address - Country:US
Practice Address - Phone:503-481-7062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR086005042LPN164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse