Individual
KENNETH GEORGE LIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 652-2880
Mailing address
13845 SE MOUNTAIN CREST DR, PORTLAND, OR 97086-6751
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD24371
OR
Other
Enumeration date
08/29/2006
Last updated
05/04/2021
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