Individual
MS. VICKI LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
17727 E BURNSIDE ST, PORTLAND, OR 97233-4803
(503) 215-9800
Mailing address
4400 NE HALSEY ST, BLDG 1, STE 129, PORTLAND, OR 97213-1545
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
089000503N1
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125757
—
OR
Enumeration date
05/04/2006
Last updated
09/28/2020
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