Individual
EMILY ELIZABETH LUNDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 NW 23RD AVE, PORTLAND, OR 97210-2906
(503) 413-7074
(503) 413-6892
Mailing address
1447 NW 12TH AVE APT 517, PORTLAND, OR 97209-2672
(715) 781-7125
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD219856
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2021
Last updated
05/09/2024
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