Most Relevant Information
Provider Data
| NPI Number: | 1003425489 |
| Provider Name: | A'LISSA RICHARDS PMHNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 202006706NP-PP |
Most Important Dates
| Enumeration Date: | 07/30/2020 |
| Last Updated: | 07/30/2020 |
Provider Practice Location
12121 E BURNSIDE ST
PORTLAND
OR
972163737
Practice Location Phone/Fax
| Phone: | 9713617700 |
| Fax: |
Provider Mailing Location
12121 E BURNSIDE ST
PORTLAND
OR
972163737
Provider Mailing Phone/Fax
| Phone: | 9713617700 |
| Fax: |