Individual
LIZZIE COLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5000 N WILLAMETTE BLVD, PORTLAND, OR 97203
(503) 943-7211
Mailing address
913 NW GARDEN VALLEY BLVD, ROSEBURG, OR 97471-6523
(541) 440-1000
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
201802416NP-PP
OR
363LP2300X
Primary Care Nurse Practitioner
Primary
201802416NP-PP
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2014
Last updated
06/06/2018
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