Individual
KRISTINE LETHERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, MAIL CODE L586, PORTLAND, OR 97239-3011
(503) 494-8534
Mailing address
3181 SW SAM JACKSON PARK RD, MAIL CODE L586, PORTLAND, OR 97239-3011
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A94278
CA
207R00000X
Internal Medicine Physician
Primary
MD 29393
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A942780
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
04/18/2007
Last updated
11/29/2021
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