Individual
DR. LISA D BENARON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9135 SW BARNES RD, PORTLAND, OR 97225-6646
(503) 216-2339
Mailing address
PO BOX 3158, ATTN: FINANCE, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G073527
CA
207R00000X
Internal Medicine Physician
Primary
MD180082
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500718597
—
OR
Enumeration date
11/01/2006
Last updated
12/17/2019
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