Individual
REBECCA LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9555 SW BARNES RD, STE 301, PORTLAND, OR 97225-6663
(503) 297-3371
(503) 297-7975
Mailing address
9555 SW BARNES RD, STE 301, PORTLAND, OR 97225-6663
(503) 297-3371
(503) 297-7975
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD23772
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275538
—
OR
05
—
8371197
—
WA
Enumeration date
06/12/2006
Last updated
05/26/2011
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