Healthcare Provider Details

I. General information

NPI: 1659391233
Provider Name (Legal Business Name): LESLIE O FRANSON D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 12/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 NE 122ND AVE
PORTLAND OR
97230-1914
US

IV. Provider business mailing address

1701 NE 122ND AVE
PORTLAND OR
97230-1914
US

V. Phone/Fax

Practice location:
  • Phone: 503-255-1381
  • Fax: 503-255-1208
Mailing address:
  • Phone: 503-255-1381
  • Fax: 503-255-1208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberDP00094
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: