NPI 1174944557

Lisa Hardy

Practitioner Dental Assistant Tigard, OR

Practice location

Address: 7105 SW Hampton St, Tigard, OR 97223-8314
Phone: (503) 684-9274
Mailing address: 6428 SE 91st Ave, Portland, OR 97266-5222

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X Licence 120494 (OR)

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Registry record

NPI: 1174944557
Entity type: Individual
Sex (as registered): Female
NPI issued: 2 Jan 2014
Record last updated: 2 Jan 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.