Provider Demographics
NPI:1750341079
Name:DRLICA, KAREN JANETTE (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:JANETTE
Last Name:DRLICA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8521 SW LEAHY RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6421
Mailing Address - Country:US
Mailing Address - Phone:503-292-3358
Mailing Address - Fax:503-292-5967
Practice Address - Street 1:8521 SW LEAHY RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6421
Practice Address - Country:US
Practice Address - Phone:503-292-3358
Practice Address - Fax:503-292-5967
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR99462084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry