Individual
KENNETH B. LEASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
19400 NW EVERGREEN PKWY, HILLSBORO, OR 97124-7031
(503) 645-2762
Mailing address
19400 NW EVERGREEN PKWY, HILLSBORO, OR 97124-7031
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
OR 079043505N3
OR
Other
Enumeration date
09/15/2006
Last updated
07/15/2007
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