Individual
MS. LISA ANN WHITMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, DEPT OF ANESTHESIOLOGY, PORTLAND, OR 97239-3011
(503) 494-8311
Mailing address
7309 SE HARRISON CT, PORTLAND, OR 97215-4141
(845) 774-9729
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201050053NP
OR
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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