Lisa Mae Cowan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00679 Issued in OR

Practice address

19260 SW 65TH Ave Ste 270
Tualatin, OR 97062

Phone

(503) 885-9391

Fax

(503) 563-5520

NPI assigned

Nov 2, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: lcowan18011@directmsg.bmctotalcare.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1003807884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19260 SW 65TH AVE",
            "address_2": "STE 270",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970625705",
            "telephone_number": "503-885-9391",
            "fax_number": "503-563-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19260 SW 65TH AVE STE 270",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "97062",
            "telephone_number": "503-885-9391",
            "fax_number": "503-563-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWAN",
        "first_name": "LISA",
        "middle_name": "MAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA00679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "R113018",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215608",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jovani Corona
• Devin Corrigan, MD
• Magdalenne Marie Corso, MD
• Gregory A Cost, MD
• Erin Counts, BS
• Michael Cowles, APRN
• Serena M Cox, OD
• Robert M Craft, MD
• Alison B Craker, LPC
• Andrew Benjamin Cramer, M.D.

• Physician Assistant in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.