Lisa Denise Broadous

NPI 1114140696 - Adult Companion - 372600000X

NPI Details
NPI 1114140696
Gender Female
Enumeration Date 04/11/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
2330 NE SISKIYOU ST
PORTLAND OR, 97212-2471, US
Phone (503) 528-0757
Fax
Business Location
6903 N ALBINA AVE
PORTLAND OR, 97217-1603, US
Phone (503) 415-1892
Fax
Toxanomy
Taxonomy Code 372600000X
License State
License Number
Remove 1114140696 NPI Number
 

According to our database, Mrs. Lisa Denise Broadous NPI is 1114140696, taxonomy code is 372600000X Lisa Denise Broadous physically located at 2330 Ne Siskiyou St, Portland OR, 97212-2471. NPI Number Lisa Denise Broadous has the Individual type.

Sponsored links

1114140696 NPI number is provided on an as is basis without warranty of any kind. 1114140696 is maintained by the National Plan & Provider Enumeration System. The contents of Lisa Denise Broadous are for informational purposes only.