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Individual

LEE CORDOVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1001 MOLALLA AVE, STE 100, OREGON CITY, OR 97045-3788
(503) 656-5273
(503) 650-4828
Mailing address
6 CENTERPOINTE DR, STE 200, LAKE OSWEGO, OR 97035-8653
(503) 797-2268
(503) 234-8227

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD09119
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110154334
RR PIN NUMBER
05
238659
OR
Enumeration date
05/16/2006
Last updated
02/14/2012
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