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Individual

LISA KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
IBCLC

Contact information

Practice address
1401 N 10TH AVE, STAYTON, OR 97383-1311
(503) 769-9200
Mailing address
4935 WAGON RIM CT SE, SALEM, OR 97317-5796
(503) 480-6662

Taxonomy

Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
LC-LC-10189374
OR

Other

Enumeration date
06/10/2025
Last updated
06/10/2025
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