Individual
LOUIS SAMUELS LIBBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 NE 99TH AVE, SUITE 200, PORTLAND, OR 97220-9428
(503) 963-3030
(503) 963-3140
Mailing address
847 NE 19TH AVE, SUITE 300, PORTLAND, OR 97232-2684
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD14297
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003912
—
WA
05
—
124487
—
OR
Enumeration date
08/22/2005
Last updated
11/16/2021
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