LISA DIANE CLARK (NPI# 1942276282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942276282 |
| Entity Type | Individual |
| Full Name | LISA DIANE CLARK |
| Credential | FNP |
| Practice Address |
265 N Broadway St Portland OR 97227-1800 |
| Practice Telephone | 5032744885 |
| Practice Fax Number | 5032744814 |
| Mailing Telephone | 5032744885 |
| Mailing Fax Number | 5032744814 |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2011-12-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
200550098 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1022791 | 05 | |
| OR | 273968 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154776912 | Lisa Clark | Counselor | 8722 Heaton St, New Orleans, LA 70118-2616 | 2016-04-29 |
| 1548694383 | Lisa G Clark | Speech-Language Pathologist | 2405 Champaign Ave, Mattoon, IL 61938-2646 | 2013-08-28 |
| 1073857801 | Lisa Ann Clark | Specialist | 1110 Chenango St, Binghamton, NY 13901-1668 | 2012-11-16 |
| 1952680324 | Lisa S Clark | Counselor | 1223 Meadow Lake Rd, Rockledge, FL 32955-8403 | 2011-08-16 |
| 1134456445 | Lisa Lynn Clark | Occupational Therapist | 85 Lunt Rd, Brunswick, ME 04011-7289 | 2009-11-06 |
| 1437485836 | Lisa Landers Clark | Counselor | 1 Waterford Ln, Savannah, GA 31411-1305 | 2009-10-20 |
| 1710146220 | Lisa M Clark | Nurse Practitioner | University Hosp Medical Center Stony Brk, Dept Pediatrics Hsc 11th Floor, Stony Brook, NY 11794-0001 | 2008-06-09 |
| 1376742841 | Lisa M Clark | Specialist | 4308 N 26th St, Tacoma, WA 98407-5211 | 2007-07-15 |
| 1356453260 | Lisa M Clark | Dentist | Bonham Family Dentistry, 101 E 9th Street, Bonham, TX 75418 | 2006-08-31 |
| 1598779100 | Lisa Bardy Clark | Family Medicine | 12815 Highway 98 West, Suite 116, Destin, FL 32550 | 2006-07-28 |
| Street Address |
265 N BROADWAY ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227-1800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851394878 | Jennifer Hope Christiansen | Physician Assistant | 265 N Broadway St, Portland, OR 97227-1800 | 2005-05-23 |
| 1114285301 | Charlotte Haws | Physician Assistant | 265 N Broadway St, Portland, OR 97227-1800 | 2012-04-25 |
| 1457659922 | Vanessa Kathleen Sanne | Nurse Practitioner | 265 N Broadway St, Portland, OR 97227-1800 | 2011-03-08 |
| 1972562809 | Jody Lynn Kujovich | Internal Medicine | 265 N Broadway St, Portland, OR 97227-1800 | 2006-03-20 |
| 1295716496 | William Edward Winter IIi | Obstetrics & Gynecology | 265 N Broadway St, Portland, OR 97227-1800 | 2005-11-07 |
| 1417949124 | Tony V Ho | Internal Medicine | 265 N Broadway St, Portland, OR 97227-1800 | 2005-08-18 |
| 1811990484 | Paul Chien-chung Tseng | Obstetrics & Gynecology | 265 N Broadway St, Portland, OR 97227-1800 | 2005-05-27 |
| 1841293420 | Spencer Hsiao-yang Shao | Internal Medicine | 265 N Broadway St, Portland, OR 97227-1800 | 2005-05-27 |
| 1942203534 | Gerald Marc Segal | Internal Medicine | 265 N Broadway St, Portland, OR 97227-1800 | 2005-05-27 |
| 1730182395 | Ralph Elliott Weinstein | Internal Medicine | 265 N Broadway St, Portland, OR 97227-1800 | 2005-05-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
| 1851955975 | Erin Marie Staples | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave;, Suite 230, Portland, OR 97227 | 2019-04-24 |
| 1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
| 1730615071 | Mehran Giblin | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave, Suite 230, Legacy Clinic Emanuel, Portland, OR 97227 | 2017-05-05 |
| 1730623687 | Christina Grace Belter | Optometrist | 300 N Graham St Ste 300, Portland, OR 97227 | 2016-12-12 |
| 1407300205 | Jenna Abernathy | Counselor | 3537 N Williams Ave, Portland, OR 97227 | 2016-08-09 |
| 1215390760 | Tanya Marie Woods | Massage Therapist | 3808 N. Williams Ave., Portland, OR 97227 | 2016-04-01 |
| 1033596853 | Eric Allen Martin | Counselor | 2054 N. Vancouver Ave, Portland, OR 97227 | 2015-04-30 |
| 1285040436 | Berk Neurosurgical LLC | Neurological Surgery | 501 N Graham St Ste 500, Portland, OR 97227 | 2014-07-09 |
| Find all providers in zip 97227 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043822794 | Danielle Langer | Nurse Practitioner | 35 Ridgeview Rd, Portland, CT 06480-4014 | 2020-08-23 |
| 1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
| 1114566650 | Sadie Garnache-poirier | Nurse Practitioner | 65 W Commercial St Ste 107, Portland, ME 04101-4789 | 2020-01-02 |
| 1902441629 | Jennifer Marie Colpitts | Nurse Practitioner | 1600 Congress St Ste B, Portland, ME 04102-2148 | 2019-11-18 |
| 1477102689 | Raquel A Bishop | Nurse Practitioner | 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 | 2019-09-10 |
| 1265081640 | Christina Lee | Nurse Practitioner | 144 State St # 1, Portland, ME 04101-3776 | 2019-09-09 |
| 1407401474 | Abby Christine Vopal | Nurse Practitioner | 66 Bramhall St Fl 1, Portland, ME 04102-3355 | 2019-08-07 |
| 1770145294 | Cynthia Marie Martinez | Nurse Practitioner | 1145 Austin St, Portland, TX 78374-2013 | 2019-07-04 |
| 1528532306 | Matthew James Keelin | Nurse Practitioner | 6801 Ne Cornfoot Rd, Portland, OR 97218-2743 | 2019-01-15 |
| 1659847580 | Colleen Jeanette Scott | Nurse Practitioner | 650 Nw Irving St, Portland, OR 97209-1272 | 2018-10-18 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.