Individual
DR. LEILA CLARK BENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
938 NW KINGS BLVD, CORVALLIS, OR 97330-2505
(541) 758-5047
(541) 758-3713
Mailing address
PO BOX 1418, CORVALLIS, OR 97339-1418
(805) 286-3826
(805) 221-6843
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
MD60027940
WA
2085R0202X
Diagnostic Radiology Physician
Primary
MD201700
OR
2085R0202X
Diagnostic Radiology Physician
MD60027940
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0293142
L&I
WA
05
—
2017309
—
WA
01
—
319557
L & I PROVIDER NUMBER
WA
01
—
322487
L & I PROVIDER NUMBER
WA
01
—
322488
L & I PROVIDER NUMBER
WA
05
—
500674855
—
OR
Enumeration date
10/02/2006
Last updated
04/16/2021
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