Healthcare Provider Details

I. General information

NPI: 1447632146
Provider Name (Legal Business Name): LISA CUNEO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2015
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10315 NE TANASBOURNE DR
HILLSBORO OR
97124-7836
US

IV. Provider business mailing address

1885 NW QUIMBY ST APT 209
PORTLAND OR
97209-2181
US

V. Phone/Fax

Practice location:
  • Phone: 800-213-2000
  • Fax:
Mailing address:
  • Phone: 408-892-5828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOL60560489
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO189142
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: