Individual
LORI LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 273-5053
Mailing address
22665 SW 94TH TER, TUALATIN, OR 97062-7242
(503) 691-9536
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
—
OR
Other
Enumeration date
07/25/2007
Last updated
07/25/2007
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