Individual
LISA ANNE BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Contact information
Practice address
6800 SW 105TH AVE, BEAVERTON, OR 97008-5468
(503) 430-1777
Mailing address
6800 SW 105TH AVE, BEAVERTON, OR 97008-5468
(503) 430-1777
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10037575
OR
363LA2200X
Adult Health Nurse Practitioner
100375775
OR
Other
Enumeration date
09/27/2006
Last updated
12/16/2025
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