Provider Demographics
NPI:1245126457
Name:RAYDO, LORI ELIZABETH (LMT)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:ELIZABETH
Last Name:RAYDO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4948 SW BARBUR BLVD APT J1
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-2850
Mailing Address - Country:US
Mailing Address - Phone:850-512-6156
Mailing Address - Fax:
Practice Address - Street 1:4948 SW BARBUR BLVD APT J1
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2850
Practice Address - Country:US
Practice Address - Phone:850-512-6156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR29022225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist