Healthcare Provider Details

I. General information

NPI: 1043341662
Provider Name (Legal Business Name): LAWRENCE R. LITWER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2880 HAYES ST
NEWBERG OR
97132-1310
US

IV. Provider business mailing address

2775 SW JADE AVE
PORTLAND OR
97225-3244
US

V. Phone/Fax

Practice location:
  • Phone: 503-537-9600
  • Fax:
Mailing address:
  • Phone: 503-780-8860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number16741
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: