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Individual

JOANNA L LEZAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
1130 NW 22ND AVE, SUITE 110, PORTLAND, OR 97210-2900
(503) 413-3940
(503) 413-1860
Mailing address
1130 NW 22ND AVE, SUITE 110, PORTLAND, OR 97210-2900
(503) 413-3940
(503) 413-1860

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
200450078NP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
275455
OR
Enumeration date
05/27/2005
Last updated
01/30/2024
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