Individual
DR. PHILLIP ANDREW LETOURNEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10330 SE 32ND AVE STE 210, MILWAUKIE, OR 97222-6594
(503) 723-6525
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD166131
OR
2086S0102X
Surgical Critical Care Physician
MD166131
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500627898
—
OR
01
—
8L6630
MEDICARE PTAN
TX
Enumeration date
10/26/2009
Last updated
02/10/2023
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