Individual
DR. LISA JOY MICHELBRINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1698 E MCANDREWS RD, SUITE 300, MEDFORD, OR 97504-5589
(541) 732-7950
(541) 732-7901
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(541) 732-7950
(541) 732-7901
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD150691
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500624563
—
OR
01
—
P00308137
MEDICARE RAILROAD
WA
Enumeration date
11/16/2005
Last updated
03/22/2021
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