MEDICARE: LESTER F TENGSICO DPM

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
1	213E00000X	Podiatrist	DP00263	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538124904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESTER F TENGSICO DPM

Provider Business Mailing Address
First Line	:	PO BOX 33912
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97292-3912
Country	:	US
Telephone Number	:	503-760-5151
Fax Number	:	503-972-2195

Provider Business Practice Location Address
First Line	:	7505SEPOWELL BLVD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97206-2453
Country	:	US
Telephone Number	:	503-760-5151
Fax Number	:	503-972-2195

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	11/03/2015

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