MEDICARE: MS. LISA CAROL FRANCOLINI L.AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	0283	OR

General Provider Information

NPI Number	:	1548244411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LISA CAROL FRANCOLINI L.AC.

Provider Business Mailing Address
First Line	:	3124 NE 25TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97212-2501
Country	:	US
Telephone Number	:	503-335-7148
Fax Number	:

Provider Business Practice Location Address
First Line	:	5441 SW MACADAM AVE
Second Line	:	SUITE 200
City	:	PORTLAND
State	:	OR
Zip	:	97239-6106
Country	:	US
Telephone Number	:	503-246-0103
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	07/08/2007

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