Individual
LILY A UZZAMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP STUDENT
Contact information
Practice address
52377 SW OLD PORTLAND RD, SUITE C, SCAPPOOSE, OR 97056
(503) 418-4222
Mailing address
51377 SW OLD PORTLAND RD STE C, SCAPPOOSE, OR 97056-4023
(503) 418-4222
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201240897RN
OR
363LF0000X
Family Nurse Practitioner
Primary
202212410NP-PP
OR
Other
Enumeration date
10/02/2020
Last updated
07/20/2023
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