Individual
LAUREN ELIZABETH CIOLLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.C.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7820
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7820
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA150467
OR
363AS0400X
Surgical Physician Assistant
PA150467
OR
363AS0400X
Surgical Physician Assistant
PA60120088
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500615034
—
OR
05
—
8560195
—
WA
Enumeration date
11/04/2009
Last updated
10/01/2024
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