Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | DO26017 | OR |
NPI | 1003881327 |
---|---|
Provider Name | Dr. Lee E. Dorfman |
First Address | Portland, OR 97208-2040 |
Second Address | Portland, OR 97209-2601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 15/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
213500 | (05) | OR |
8432544 | (05) | WA |
I38168 | (02) | |
P00240609 | RR MEDICARE (01) | OR |