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Dr. Gerald T. Lisac, MD
Specialist in West Linn, Oregon
NPI 1003950684

Gerald T. Lisac is a Specialist based in West Linn, OR. Gerald T. Lisac practices in West Linn, OR and has the professional credentials of MD. The NPI Number for Gerald T. Lisac is 1003950684 and holds a License No. MD06539 (Oregon).

The current practice location address for Gerald T. Lisac is 276 Sw Forest Cove Rd, West Linn, OR and can be reached out via phone at 503-557-3679 and via fax at 503-557-3680. You can also correspond with Gerald T. Lisac through the mailing address at PO BOX 646, WEST LINN, OR - 97068-0646 (mailing address contact number: 503-557-3679).

Location: 276 Sw Forest Cove Rd, West Linn, OR, 97068-0646
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003950684
Provider Name
Gerald T. Lisac
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
276 Sw Forest Cove Rd, West Linn, OR, 97068-0646
Phone Number
503-557-3679
Fax Number
503-557-3680
Provider Enumeration Date
02/16/2007
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
D72976 01 OR PROV. HEALTH PLAN
107722 05 OR
institution
Provider Business Practice Location Address Details
Address
276 Sw Forest Cove Rd
City
West Linn
State
Oregon
Zip
97068-9401
Phone Number
503-557-3679
Fax Number
503-557-3680
person
Provider Business Mailing Address Details
Address
276 Sw Forest Cove Rd
City
West Linn
State
Oregon
Zip
97068-9401
Phone Number
503-557-3679
Fax Number
503-557-3680
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
MD06539 (Oregon)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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