Individual
MISS LACEY JOY MCCARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1225 NE 2ND AVE, PORTLAND, OR 97232-2003
(503) 944-8000
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201400152RN
OR
363LF0000X
Family Nurse Practitioner
Primary
202210076NP-PP
OR
363LF0000X
Family Nurse Practitioner
AP61100479
WA
Other
Enumeration date
04/30/2014
Last updated
12/23/2024
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