Individual
LISA OSBORNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4120
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4120
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0024164186
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
201608493CRNA
OR
Other
Enumeration date
10/04/2006
Last updated
02/13/2017
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