Individual
LISA ANN CALLANTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 NE IRVING ST, SUITE 250, PORTLAND, OR 97232-2243
(503) 233-4356
Mailing address
15620 SE FRANCIS AVE, MILWAUKIE, OR 97267-3032
(503) 654-1728
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OR
Other
Enumeration date
02/24/2009
Last updated
02/24/2009
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