Grant, Lisa C

Grant, Lisa C is an individual health care provider with primary practice located at 1615 E 12Th St Suite 100, The Dalles OR 97058-3278. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Grant, Lisa C can be contacted via phone (541) 296-1100.

Contact Information

Primary practice address
1615 E 12Th St Suite 100 The Dalles OR 97058-3278
Phone: (541) 296-1100
Fax: (541) 236-0606
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X MD24969 Oregon

Profile Details

NPI number 1801805627
LBN Legal business name Grant, Lisa C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 8th, 2006
Last updated Dec 5th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801805627 NPPES
Oregon MEDICAID 233198
Oregon MEDICAID 8402315

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