Individual
EMILY CRAIG AGAN LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
C192393
CO
Other
Enumeration date
03/01/2020
Last updated
07/31/2024
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