Individual
DR. JORDON G LUBAHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10819 SE STARK ST, PORTLAND, OR 97216-3161
(503) 255-2291
(503) 252-1797
Mailing address
PO BOX 22009, PORTLAND, OR 97269-2009
(503) 558-7372
(503) 344-5140
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
161328
OR
207W00000X
Ophthalmology Physician
ME112134
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500655796
—
OR
Enumeration date
04/11/2008
Last updated
02/20/2021
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