Individual
LYDIA PEARL OLSON STANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
2800 N VANCOUVER AVE, PORTLAND, OR 97227-1630
(503) 413-4500
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
10028797
OR
Other
Enumeration date
10/30/2024
Last updated
01/08/2025
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