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Individual

DR. LORI LEE MCMULLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-6101
(503) 494-1159
Mailing address
2054 RIVERSIDE AVE, APARTMENT 2204, JACKSONVILLE, FL 32204-4428

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD25413
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
277846
OR
05
807283400
ID
05
8437543
WA
Enumeration date
07/22/2006
Last updated
02/04/2022
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