Individual
DR. LISA JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
214 N RUSSELL ST, PORTLAND, OR 97227-1620
(503) 494-7428
(503) 284-1398
Mailing address
7717 SW 34TH AVE, PORTLAND, OR 97219-1725
(503) 246-2564
(503) 246-0748
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8631
OR
Other
Enumeration date
04/18/2007
Last updated
07/24/2012
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