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Individual

KARA LYNN LIECHTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNS-PP

Contact information

Practice address
1130 NW 22ND AVE STE 345, PORTLAND, OR 97210-2978
(503) 413-7513
Mailing address
1130 NW 22ND AVE STE 345, PORTLAND, OR 97210-2978
(503) 413-7513

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201609037RN
OR
364S00000X
Clinical Nurse Specialist
Primary
202004895CNS-PP
OR

Other

Enumeration date
10/08/2020
Last updated
05/17/2021
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