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Individual

DR. DEREK JAMES LEINENBACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9205 SW BARNES RD STE MT-2800, PORTLAND, OR 97225-6603
(503) 216-2621
Mailing address
2494 NW ROGUE VALLEY TER, BEAVERTON, OR 97006-8143
(503) 530-8078

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
LL18730
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LL18730
OREGON LICENSE NUMBER
OR
Enumeration date
07/06/2009
Last updated
07/06/2009
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