Individual
LISA M EMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 GWEE SHUT RD, SILETZ, OR 97380-2036
(541) 444-1030
Mailing address
PO BOX 320, SILETZ, OR 97380-0320
(541) 444-1030
(541) 444-9695
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD25151
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022663
—
OR
Enumeration date
08/22/2005
Last updated
05/12/2022
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