| Doctor Name: | LISA ADAIR MITCHELL |
| NPI Number: | 1003133125 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LPC |
| License Number: | C1243 |
| Business Practice Address: | 7180 Sw Fir Loop, Suite 1-a Portland, OR - 972238023 |
| Business Phone Number: | 5032142645 |
| Business Fax Number: | 5036203453 |
| Mailing Address: | 7180 Sw Fir Loop,, Suite 1-a PORTLAND |
| State: | OR |
| Postal Code: | 972238023 |
| Phone Number: | 5032142645 |
| Fax Number: | 5036203453 |
| NPI Enumeration Date: | 04/29/2010 |
| NPI Last Update Date: | 04/29/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | C1243 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |