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General NPI Number Information
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NPI Number | 1609090398
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Entity Type | Individual
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Provider Name | LISA RENE HODGERS BAYNE FNP
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Gender | Female
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 9701 SW BARNES RD STE 150
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City | PORTLAND
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State | OR
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Zip | 97225-6689
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Country | US
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Telephone | 503-734-3535
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Fax | 503-734-3530
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Provider Business Mailing Address
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Address Line | 7650 SW BEVELAND RD STE 200
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City | PORTLAND
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State | OR
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Zip | 97223-8692
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Country | US
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Telephone | 503-601-3615
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Fax | 503-646-1683
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 200650137NP
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License Number State | OR
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