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1669703641
LISA RENEE MATLOCK
SALEM, OR
NPI
1669703641
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Former Name
LISA RENEE LOGIUDICE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: OR 201050187NP)
Enumeration Date
2010-01-15
Last Update Date
2022-03-31
Business Address
Mrs. LISA RENEE MATLOCK FNP
2020 CAPITOL ST NE
SALEM, OR 97301-0644
Phone number: 503-399-2424
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Mailing Address
Mrs. LISA RENEE MATLOCK FNP
890 OAK ST SE
SALEM, OR 97301-3905
Phone number: 503-561-5200
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