Individual
LAUREN MEREDITH CHAMPION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1015 NW 22ND AVE, PORTLAND, OR 97210
(503) 413-7711
Mailing address
1015 NW 22ND AVE, PORTLAND, OR 97210
(503) 413-7711
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO182283
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PG178443
OREGON MEDICAL BOARD
OR
Enumeration date
05/20/2014
Last updated
06/28/2019
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