Individual
MEGHAN LOUISE LACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
11790 SW BARNES RD, BLG. A, SUITE 140, PORTLAND, OR 97225
(503) 643-2100
Mailing address
3952 CARMAN DR, LAKE OSWEGO, OR 97035-2471
(503) 853-4430
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
201707003NP-PP
OR
Other
Enumeration date
08/29/2017
Last updated
08/29/2017
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