Individual
DR. LANCE J. CADDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
707 SW WASHINGTON ST, SUITE 700, PORTLAND, OR 97205-3536
(503) 299-9906
(503) 225-9002
Mailing address
PO BOX 2040, PORTLAND, OR 97208-2040
(503) 299-9906
(503) 225-9002
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD12078
OR
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD12078
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170738
—
OR
01
—
757051043
RR MEDICARE
OR
05
—
8124398
—
WA
05
—
MD842OR
—
AK
Enumeration date
02/15/2006
Last updated
09/09/2013
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