Aurora Lake, NP

NURSE PRACTITIONER

1015 Nw 22nd Ave

Portland, OR 972103025

(503) 413-7711

**NPI:** 1538609938

**Med School:** OTHER

**Experience:** 10 years

**Telehealth:** No

**Medicare Assignment:** Yes

Practice Locations (1)

LEGACY CLINICS LLC

1015 Nw 22nd Ave
Portland, OR 972103025

Phone: (503) 413-7711

**Group ID:** 0244144004 | **Group Size:** 635 members

LEGACY EMANUEL MEDICAL CENTER Type: Hospital
2801 N GANTENBEIN AVENUE
Phone: (503) 413-2200
Medicare CCN: 380007 View Profile

MIPS performance data is not available or not publicly reported.

Procedure volume data is not available for public display.

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