Provider Demographics
NPI:1215536602
Name:LAPOMA, DARIO J (PMHNP-DNP)
Entity Type:Individual
Prefix:
First Name:DARIO
Middle Name:J
Last Name:LAPOMA
Suffix:
Gender:M
Credentials:PMHNP-DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 SE ANKENY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1622
Mailing Address - Country:US
Mailing Address - Phone:503-298-9165
Mailing Address - Fax:949-695-3794
Practice Address - Street 1:2006 SE ANKENY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1622
Practice Address - Country:US
Practice Address - Phone:503-298-9165
Practice Address - Fax:949-695-3794
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-18
Last Update Date:2023-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10014568363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty