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Individual

MRS. LISA RENEE MERTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
2627 NE BROADWAY ST, PORTLAND, OR 97232-1720
(503) 473-9339
(503) 281-0278
Mailing address
2627 NE BROADWAY ST, PORTLAND, OR 97232-1720
(503) 473-9339
(503) 281-0278

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12050
OR

Other

Enumeration date
05/21/2007
Last updated
02/11/2010
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