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1497936629
LISA TEAGUE
PORTLAND, OR
NPI
1497936629
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Former Name
LISA BOAL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: OR 11219)
Enumeration Date
2007-11-15
Last Update Date
2007-11-15
Business Address
-- LISA TEAGUE LMT
511 SW 10TH AVE STE 1109
PORTLAND, OR 97205-2712
Phone number: 503-329-3577
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Mailing Address
-- LISA TEAGUE LMT
2083 NW JOHNSON ST. #34
PORTLAND, OR 97209
Phone number: 503-329-3577
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