Individual
MICHAEL ALEXANDER LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1040 NW 22ND AVE, SUITE 420, PORTLAND, OR 97210-3057
(503) 963-3100
(503) 459-5398
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
(503) 413-3900
(503) 413-3710
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD177213
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2059497
—
WA
05
—
500708914
—
OR
Enumeration date
04/27/2012
Last updated
03/26/2018
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