Individual
LISA MARIE CAMPOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1925 NW 173RD AVE, APT #1610, BEAVERTON, OR 97006-7319
(503) 997-0680
Mailing address
1925 NW 173RD AVE, APT #1610, BEAVERTON, OR 97006
(503) 997-0680
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18388
OR
Other
Enumeration date
04/20/2012
Last updated
04/20/2012
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