Individual
LEIA V CHANCELLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10123 SE MARKET ST, PORTLAND, OR 97216-2532
(503) 257-2500
(503) 261-6790
Mailing address
10123 SE MARKET ST, PORTLAND, OR 97216-2532
(503) 257-2500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD186855
OR
208M00000X
Hospitalist Physician
Primary
MD186855
OR
390200000X
Student in an Organized Health Care Education/Training Program
PG172362
OR
Other
Enumeration date
05/22/2015
Last updated
02/12/2025
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