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Individual

MRS. LISA A BURNELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MED, CADCII

Contact information

Practice address
134 SE 5TH AVE STE C, HILLSBORO, OR 97123-4095
(503) 621-8735
(503) 214-8911
Mailing address
134 SE 5TH AVE STE C, HILLSBORO, OR 97123-4095
(503) 621-8735
(503) 214-8911

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
02-R-13
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1457404410
INNER JOURNEY HEALING ARTS CENTER
OR
05
278095
OR
Enumeration date
11/07/2008
Last updated
03/09/2023
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