Individual
LISA J CHICKADONZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
2705 E BURNSIDE ST, SUITE 114, PORTLAND, OR 97214-1763
(503) 215-6262
(503) 234-5437
Mailing address
PO BOX 3178, PORTLAND, OR 97208-3178
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
082009965N5
OR
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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