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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801805627 | NPPES |
| Oregon | MEDICAID | 233198 | |
| Oregon | MEDICAID | 8402315 |
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