Individual
LISA ANN SEUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
417 SW 117TH AVE FL 2, PORTLAND, OR 97225
(503) 216-8980
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA189681
OR
Other
Enumeration date
06/28/2017
Last updated
07/21/2022
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