Individual
LUCY M ORTEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
555 BLACK OAK DR., SUITE 400, MEDFORD, OR 97504-8491
(541) 789-8873
(541) 789-2173
Mailing address
2825 E BARNETT RD, MSS, MEDFORD, OR 97504-8332
(541) 789-4281
(541) 789-4806
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA16935
CA
363AM0700X
Medical Physician Assistant
PA179419
OR
Other
Enumeration date
10/12/2006
Last updated
03/19/2025
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