Individual
MRS. LORENA LESLIE CLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4103 MERCANTILE DRIVE, LAKE OSWEGO, OR 97305-6772
(503) 850-9940
(503) 850-6709
Mailing address
4103 MERCANTILE DRIVE, PORTLAND, OR 97035
(503) 850-9940
(503) 850-6709
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01289
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500604992
—
OR
Enumeration date
11/09/2007
Last updated
12/11/2019
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