Individual
CHRISTINE LASICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
501 N GRAHAM ST STE 220, PORTLAND, OR 97227-2014
(503) 413-6200
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
(503) 413-3900
(503) 413-3710
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201706639NP-PP
OR
Other
Enumeration date
09/17/2017
Last updated
09/24/2018
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