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NPI Code Detail

MEDICARE: KATHERINE LEBOLD MD

MEDICARE: KATHERINE LEBOLD MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianMD219578OR

General Provider Information

NPI Number : 1245663053
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE LEBOLD MD
Provider Business Mailing Address
First Line : 3181 SW SAM JACKSON PARK RD
Second Line : OHSU
City : PORTLAND
State : OR
Zip : 97239-3011
Country : US
Telephone Number : 503-494-8220
Fax Number :
Provider Business Practice Location Address
First Line : 3181 SW SAM JACKSON PARK RD
Second Line : OHSU
City : PORTLAND
State : OR
Zip : 97239-3011
Country : US
Telephone Number : 503-494-8220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2013
Last Update Date : 05/04/2026

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Directions to “ KATHERINE LEBOLD MD” Practice Location

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