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Individual

DR. LISA LOUISE MCCLUSKEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
9555 SW BARNES RD, STE 150, PORTLAND, OR 97225-6663
(503) 297-7403
(503) 297-3096
Mailing address
9555 SW BARNES RD, STE 150, PORTLAND, OR 97225-6663
(503) 297-7403
(503) 297-3096

Taxonomy

Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
MD21717
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1018856
WA
05
134018
OR
Enumeration date
05/24/2005
Last updated
12/22/2011
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