Individual
MRS. LISA M BRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
4515 NE FREMONT ST, PORTLAND, OR 97213-1175
(503) 281-4760
Mailing address
5124 NE MASON CT, PORTLAND, OR 97218-2138
(503) 336-1205
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
027722
OR
Other
Enumeration date
01/15/2009
Last updated
01/15/2009
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