Individual
LAM L LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25500 SE STARK ST STE 102, GRESHAM, OR 97030-8327
(503) 492-1327
Mailing address
2113 NW 17TH AVE, CAMAS, WA 98607-4101
(503) 492-1327
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
4710
OR
175F00000X
Naturopath
NT60809300
WA
207Q00000X
Family Medicine Physician
ML 60225309
WA
Other
Enumeration date
06/16/2011
Last updated
03/17/2018
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