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1699874081
LISA A FARGO
BEAVERTON, OR
NPI
1699874081
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: OR 11230)
Enumeration Date
2006-09-21
Last Update Date
2007-07-08
Business Address
Mrs. LISA A FARGO LMT
3800 SW CEDAR HILLS BLVD #203
BEAVERTON, OR 97005-2027
Phone number: 971-645-2257
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Mailing Address
Mrs. LISA A FARGO LMT
13165 SW ESSEX DR
TIGARD, OR 97223-5646
Phone number: 971-645-2257
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