Sullivan, Lisa C.

Sullivan, Lisa C. is an individual health care provider with primary practice located at 4950 Se Roethe Rd , Milwaukie OR 97267-5746. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Sullivan, Lisa C. can be contacted via phone (503) 722-6858.

Contact Information

Primary practice address
4950 Se Roethe Rd Milwaukie OR 97267-5746
Phone: (503) 722-6858
Fax: (503) 722-6826
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD24619 Oregon

Profile Details

NPI number 1841380375
LBN Legal business name Sullivan, Lisa C.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2006
Last updated Jun 27th, 2019 - about 6 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1841380375 NPPES
Oregon MEDICAID 096511
Oregon MEDICAID 240558
Oregon MEDICAID 22959

Popular Providers