Healthcare Provider Details

I. General information

NPI: 1336183474
Provider Name (Legal Business Name): LESLEY E GARBER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 INLAND SHORES WAY N
KEIZER OR
97303-3883
US

IV. Provider business mailing address

PO BOX 8100
SALEM OR
97303-0900
US

V. Phone/Fax

Practice location:
  • Phone: 503-399-2424
  • Fax: 503-375-7429
Mailing address:
  • Phone: 503-399-2424
  • Fax: 503-375-7429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD286851
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: