Individual
DR. ROM SAMUEL LEIDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4805 NE GLISAN ST, SUITE 6N40, PORTLAND, OR 97213-2933
(503) 215-5696
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
57.012492
OH
207RX0202X
Medical Oncology Physician
MD00044911
WA
207RX0202X
Medical Oncology Physician
Primary
MD159938
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039581
LABOR & INDUSTRY
WA
05
—
8441743
—
WA
01
—
P00287631
RAILROAD MEDICARE
—
Enumeration date
08/31/2006
Last updated
03/19/2021
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