Most Relevant Information
Provider Data
| NPI Number: | 1003807884 |
| Provider Name: | LISA MAE COWAN PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA00679 |
Most Important Dates
| Enumeration Date: | 11/02/2005 |
| Last Updated: | 08/15/2018 |
Provider Practice Location
19260 SW 65TH AVE STE 270
TUALATIN
OR
97062
Practice Location Phone/Fax
| Phone: | 5038859391 |
| Fax: | 5035635520 |
Provider Mailing Location
19260 SW 65TH AVE
STE 270
TUALATIN
OR
970625705
Provider Mailing Phone/Fax
| Phone: | 5038859391 |
| Fax: | 5035635520 |