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1942276282
LISA DIANE CLARK
PORTLAND, OR
NPI
1942276282
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: OR 200550098)
Enumeration Date
2006-02-27
Last Update Date
2011-12-22
Business Address
-- LISA DIANE CLARK FNP
265 N BROADWAY ST
PORTLAND, OR 97227-1800
Phone number: 503-274-4885
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Mailing Address
-- LISA DIANE CLARK FNP
265 N BROADWAY ST
PORTLAND, OR 97227-1800
Phone number: 503-274-4885
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