Healthcare Provider Details

I. General information

NPI: 1922130210
Provider Name (Legal Business Name): JUDITH LIENHARD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 FAIRVIEW ST
SILVERTON OR
97381-1917
US

IV. Provider business mailing address

4455 SW 94TH AVE
PORTLAND OR
97225-2567
US

V. Phone/Fax

Practice location:
  • Phone: 503-873-1680
  • Fax:
Mailing address:
  • Phone: 503-384-0249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: