Individual
LISA MARCUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
290 WILLAMETTE ST, UMATILLA, OR 97882-6601
(541) 922-0880
Mailing address
702 SUNSET DR, ONTARIO, OR 97914-3121
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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