Healthcare Provider Details

I. General information

NPI: 1174501761
Provider Name (Legal Business Name): RICHARD H LEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 S GARDEN WAY STE 290
EUGENE OR
97401-8175
US

IV. Provider business mailing address

PO BOX 70368
SPRINGFIELD OR
97475-0120
US

V. Phone/Fax

Practice location:
  • Phone: 541-868-9700
  • Fax: 541-683-1709
Mailing address:
  • Phone: 541-868-9700
  • Fax: 541-246-2353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD20537
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier150307
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: