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Individual

MORGAN MELLISANDE LISNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
6355 NE CORNELL RD STE 100, HILLSBORO, OR 97124-5434
(503) 597-3130
(503) 597-3140
Mailing address
6355 NE CORNELL RD STE 100, HILLSBORO, OR 97124-5434
(503) 597-3130
(503) 597-3140

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
52984
TN
207Q00000X
Family Medicine Physician
Primary
MD196628
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003181727A
GA
05
05624779
MS
05
1134412794
MO
05
184972
AL
05
212922001
AR
05
Q019173
TN
Enumeration date
05/16/2011
Last updated
02/21/2020
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