Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD22507 | OR |
Y | 207VE0102X | Reproductive Endocrinologist | MD22507 | OR |
NPI | 1528155579 |
---|---|
Provider Name | David Michael Lee |
First Address | Portland, OR 97239-4501 |
Second Address | Portland, OR 97239-4501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2006 |
Last Update Date | 12/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
288081 | (05) | OR |
H25722 | (02) |