Provider Demographics
NPI:1952993230
Name:LEDSON, LISA REBEKKA (RN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:REBEKKA
Last Name:LEDSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 MAPLETON DR
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-2142
Mailing Address - Country:US
Mailing Address - Phone:503-949-6459
Mailing Address - Fax:
Practice Address - Street 1:4000 MAPLETON DR
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-2142
Practice Address - Country:US
Practice Address - Phone:503-949-6459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60897415163W00000X
OR200841680RN163WC1500X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health