Individual
EDWARD J LAIRSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11782 SW BARNES RD, STE 300, PORTLAND, OR 97225-5914
(503) 214-5200
(503) 906-6613
Mailing address
11782 SW BARNES RD, STE 300, PORTLAND, OR 97225-5914
(503) 214-5200
(503) 906-6613
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD24366
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227038
—
OR
01
—
MD24366
OREGON MEDICAL LICENSE
OR
Enumeration date
07/23/2006
Last updated
06/07/2021
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