Provider Demographics
NPI:1457549651
Name:KAUFMAN, LISA PFAFFINGER (PHD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:PFAFFINGER
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:NICOLE
Other - Last Name:PFAFFINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:3415 SE POWELL BLVD.
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202
Mailing Address - Country:US
Mailing Address - Phone:503-234-9591
Mailing Address - Fax:541-752-9270
Practice Address - Street 1:3415 SE POWELL BLVD.
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202
Practice Address - Country:US
Practice Address - Phone:503-234-9591
Practice Address - Fax:541-752-9270
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2395103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent