Individual
LISA MAE OSBORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., L.AC.
Contact information
Practice address
5721 SE 41ST AVE, PORTLAND, OR 97202-7517
(503) 321-5048
Mailing address
5721 SE 41ST AVE, PORTLAND, OR 97202-7517
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00660
OR
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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