Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | MD23575 | OR |
NPI | 1003808452 |
---|---|
Provider Name | Michael John Lefor |
First Address | Portland, OR 97232-2684 |
Second Address | Portland, OR 97220-9442 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2005 |
Last Update Date | 16/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
286780 | (05) | OR |
8312373 | (05) | WA |
B21761 | (02) | OR |