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NPI Code Detail

MEDICARE: LESLEY RYAN

MEDICARE: LESLEY RYAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianA72919CA
2207Q00000XFamily Medicine PhysicianMD151645OR

General Provider Information

NPI Number : 1710038203
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLEY RYAN
Provider Business Mailing Address
First Line : 1027 E BURNSIDE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97214-1328
Country : US
Telephone Number : 503-239-8400
Fax Number :
Provider Business Practice Location Address
First Line : 1427 SE 182ND AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97233-5008
Country : US
Telephone Number : 503-761-6006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2007
Last Update Date : 08/08/2024

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Directions to “ LESLEY RYAN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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