Healthcare Provider Details

I. General information

NPI: 1639184138
Provider Name (Legal Business Name): STEPHEN HENRY LAFRANCHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3181 SW SAM JACKSON PARK RD
PORTLAND OR
97239-3011
US

IV. Provider business mailing address

707 SW GAINES ST DEPT OF PEDIATRICS (CDRCP) OHSU
PORTLAND OR
97239
US

V. Phone/Fax

Practice location:
  • Phone: 503-418-5710
  • Fax:
Mailing address:
  • Phone: 503-494-1926
  • Fax: 503-494-1933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberMD09542
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: