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Contact Information

LISA ANDERSEN
5050 NE HOYT ST STE 138
PORTLAND, OR97213-2955
 Phone: 503-238-1062
 Fax: 503-233-1588
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for LISA ANDERSEN · (Female)

NPI # 1730484312
Status Active
Credentials
Entity Individual
Enumeration date 01/13/2011
Last updated 02/17/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • OR License # PA160150
Hospital affiliation(s)
  • LEGACY GOOD SAMARITAN MEDICAL CENTER - (Acute Care)
    1015 NW 22ND AVENUE, W121
    PORTLAND, OR 97210
  • PROVIDENCE ST VINCENT MEDICAL CENTER - (Acute Care)
    9205 SW BARNES ROAD
    PORTLAND, OR 97225
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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