Miura, Lisa Noelle

Miura, Lisa Noelle is an individual health care provider with primary practice located at 2800 N Vancouver Ave Suite 230, Portland OR 97227-1630. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Miura, Lisa Noelle can be contacted via phone (503) 413-4340.

Contact Information

Primary practice address
2800 N Vancouver Ave Suite 230 Portland OR 97227-1630
Phone: (503) 413-4340
Fax: (503) 413-1923
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD21271 Oregon
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X MD21271 Oregon

Profile Details

NPI number 1538128202
LBN Legal business name Miura, Lisa Noelle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2006
Last updated Oct 31st, 2011 - about 14 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 1538128202 NPPES
Oregon MEDICAID 287520

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