Individual
DR. LESLEY ANNE PORTUGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
700 S MAIN ST, MOSCOW, ID 83843-3046
(208) 882-4511
Mailing address
700 S MAIN ST, MOSCOW, ID 83843-3046
(208) 882-4511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M-14838
ID
207R00000X
Internal Medicine Physician
Primary
MD60915046
WA
208M00000X
Hospitalist Physician
M-14838
ID
208M00000X
Hospitalist Physician
MD60915046
WA
208M00000X
Hospitalist Physician
MTL-2026-009
GU
Other
Enumeration date
06/01/2015
Last updated
03/02/2026
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