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Individual

DR. DIRK JACOB VAN LEEUWEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., PH.D., FAASLD

Contact information

Practice address
10000 SE MAIN ST STE 112, PORTLAND, OR 97216-2441
(503) 255-3054
(503) 255-7651
Mailing address
10000 SE MAIN ST STE 112, PORTLAND, OR 97216-2441
(503) 255-3054

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
CP206793
OR
207RG0100X
Gastroenterology Physician
EMERGENT
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100220249
WI
Enumeration date
08/20/2006
Last updated
02/22/2023
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