Organization
LIZA SAMSON MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LIZA DE LA CRUZ SAMSON M.D. (SOLO PRACTITIONER)
(503) 705-5753
Entity
Organization
Contact information
Practice address
2456 NW NORTHRUP ST, SUITE 1A, PORTLAND, OR 97210-3253
(503) 705-5753
Mailing address
2456 NW NORTHRUP ST, SUITE 1A, PORTLAND, OR 97210-3253
(503) 705-5753
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD22590
OR
Other
Enumeration date
09/23/2009
Last updated
09/12/2012
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