| Lisa Jewell Dc Llc | |
|
510 Sw 3rd Ave Ste 210 Portland OR 97204-2507 | |
| (503) 224-5010 | |
| Not Available |
| Full Name | Lisa Jewell Dc Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 510 Sw 3rd Ave Ste 210, Portland, Oregon |
| Authorized Official Name and Position | Lisa Jewell (OWNER) |
| Authorized Official Contact | 5032245010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Jewell Dc Llc 510 Sw 3rd Ave Ste 210 Portland OR 97204-2507 Ph: (503) 224-5010 | Lisa Jewell Dc Llc 510 Sw 3rd Ave Ste 210 Portland OR 97204-2507 Ph: (503) 224-5010 |
| NPI Number | 1104332899 |
|---|---|
| Provider Enumeration Date | 12/18/2017 |
| Last Update Date | 12/18/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104332899 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 5655 (Oregon) | Primary |
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