Individual
DR. SUSAN J LECLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
707 SW WASHINGTON ST, STE 700, PORTLAND, OR 97205-3536
(503) 299-9906
(503) 225-9002
Mailing address
PO BOX 2040, PORTLAND, OR 97208-2040
(503) 299-9906
(503) 225-9002
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD22902
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050083265
RR MEDICARE
OR
05
—
287531
—
OR
05
—
806683500
—
ID
05
—
8280646
—
WA
05
—
MD078OR
—
AK
Enumeration date
07/26/2006
Last updated
09/10/2013
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