Provider Demographics
NPI:1538214036
Name:JAPPAY, ELISABETH LEE (MD)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:LEE
Last Name:JAPPAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:LEE
Other - Last Name:JAPPAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1234 COMMERCIAL ST SE
Mailing Address - Street 2:PHYSICIANS' BUILDING GROUP
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4204
Mailing Address - Country:US
Mailing Address - Phone:503-362-9334
Mailing Address - Fax:503-362-8016
Practice Address - Street 1:1234 COMMERCIAL ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4204
Practice Address - Country:US
Practice Address - Phone:503-362-9334
Practice Address - Fax:503-362-8016
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD26489207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR154505OtherMEDICARE ID TYPE UNSPECIFIED