Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | DO28780 | OR |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | DO28780 | OR |
NPI | 1518096114 |
---|---|
Provider Name | Elizabeth Placek Levesque |
First Address | Bend, OR 97708-5579 |
Second Address | Bend, OR 97701-6015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 13/01/2016 |