Individual
LISA NEVARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
425 E. 7TH STREET, THE DALLES, OR 97058-2607
(541) 296-4610
Mailing address
425 E 7TH ST, THE DALLES, OR 97058-2607
(541) 296-4610
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP30005552
WA
363LF0000X
Family Nurse Practitioner
Primary
097007189N1
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9644626
—
WA
Enumeration date
10/27/2006
Last updated
12/14/2011
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