Individual
IAN M LENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
16770 SW EDY RD STE 102, SHERWOOD, OR 97140-9679
(503) 216-9600
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DO204584
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
OR
Other
Enumeration date
04/21/2016
Last updated
06/09/2023
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