MEDICARE: LANCE LEBRECHT BEAR M.D.

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	207X00000X	Orthopaedic Surgery Physician	100891	MO
2	207X00000X	Orthopaedic Surgery Physician	MD60112511	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0259384	OTHER	WA	STATE L&I
2	0257049	OTHER	WA	STATE L&I
3	0264384	OTHER	WA	STATE L&I

General Provider Information

NPI Number	:	1952306037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LANCE LEBRECHT BEAR M.D.

Provider Business Mailing Address
First Line	:	11511 CANTERWOOD BLVD NW
Second Line	:	STE 205
City	:	GIG HARBOR
State	:	WA
Zip	:	98332-5813
Country	:	US
Telephone Number	:	253-530-2663
Fax Number	:	253-530-2675

Provider Business Practice Location Address
First Line	:	11511 CANTERWOOD BLVD NW
Second Line	:	STE 205
City	:	GIG HARBOR
State	:	WA
Zip	:	98332-5813
Country	:	US
Telephone Number	:	253-530-2663
Fax Number	:	253-530-2675

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	06/28/2011

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Directions to “ LANCE LEBRECHT BEAR M.D.” Practice Location

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