Provider Demographics
NPI:1245525328
Name:LE, LAM L (MD)
Entity type:Individual
Prefix:
First Name:LAM
Middle Name:L
Last Name:LE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2113 NW 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-4101
Mailing Address - Country:US
Mailing Address - Phone:503-492-1327
Mailing Address - Fax:
Practice Address - Street 1:25500 SE STARK ST STE 102
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-8327
Practice Address - Country:US
Practice Address - Phone:503-492-1327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML 60225309207Q00000X
WANT60809300175F00000X
OR4710175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine