Individual
MISS LISA LYNN GULICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, MAT
Contact information
Practice address
14486 SE 122ND AVE, CLACKAMAS, OR 97015-8269
(503) 353-5810
Mailing address
3525 SW BARBUR #3, PORTLAND, OR 97239
(503) 709-6791
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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