Individual
LEE MICHAEL ANTHONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9205 SW BARNES RD MT-2800, PORTLAND, OR 97225-6603
(503) 216-2621
(503) 216-7488
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD179851
OR
207R00000X
Internal Medicine Physician
PG168174
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500717033
—
OR
Enumeration date
05/22/2014
Last updated
10/20/2020
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