Individual
LISA RIETZ YANASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5050 NE HOYT ST, SUITE 315, PORTLAND, OR 97213-2991
(503) 215-8580
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
108439
AK
2084N0400X
Neurology Physician
36545
MT
2084N0400X
Neurology Physician
C144901
CA
2084N0400X
Neurology Physician
Primary
MD26024
OR
2084N0400X
Neurology Physician
MD60216893
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213502
—
OR
01
—
P01238739
RR MEDICARE (PH&S)-PMG
OR
Enumeration date
08/24/2005
Last updated
03/25/2021
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