Individual
LISA MARIE WILLIAMSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
731 POMONA ST, THE DALLES, OR 97058-4105
(541) 993-5310
Mailing address
1508 G ST, THE DALLES, OR 97058-3058
(541) 506-3743
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
6967
OR
Other
Enumeration date
07/29/2008
Last updated
07/29/2008
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