Individual
LISA SCHMUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13110 NE BEECH ST, PORTLAND, OR 97230-2847
(503) 998-5669
(503) 254-5669
Mailing address
13110 NE BEECH ST, PORTLAND, OR 97230-2847
(503) 998-5669
(503) 254-5669
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
089003023RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098071
—
OR
Enumeration date
06/26/2015
Last updated
06/26/2015
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