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Individual

DEREK SPENCER LIPMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, LTD

Contact information

Practice address
17704 JEAN WAY, STE 105, LAKE OSWEGO, OR 97035-5497
(503) 675-6776
(503) 675-2572
Mailing address
17704 JEAN WAY, STE 105, LAKE OSWEGO, OR 97035-5497
(503) 675-6776
(503) 675-2572

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD10662
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
154963
OR
Enumeration date
12/19/2005
Last updated
05/02/2012
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