LESLEY NICOLOFF OTTO MD LLC NPI 1417138769

NPI Information

NPI: 1417138769
Provider Name: LESLEY NICOLOFF OTTO MD, LLC
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Organization

Specialization: Gynecology

Address:
9155 SW BARNES RD
SUITE 634
PORTLAND, OR
ZIP 97225
Phone: (503) 297-4123
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LESLEY NICOLOFF OTTO MD, LLC is a gynecology obstetrics gynecology in Portland, OR. LESLEY NICOLOFF OTTO MD, LLC NPI is 1417138769. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9155 SW BARNES RD
SUITE 634
PORTLAND, OR
ZIP 97225-633
Phone: (503) 297-4123
Fax: (503) 297-0344

The provider's authorized official is Lesley N Otto .
The authorized official title is Physician and has the following contact phone number (503) 297-4123.

The enumeration date for this NPI number is 11/15/2007 and was last updated on 12/20/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207VG0400X	Obstetrics & Gynecology	Gynecology	MD18878	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	R132843	MEDICARE PIN	OREGON
2	MD18878	OTHER	OREGON	MEDICAL LICENSE
3	073122	MEDICAID	OREGON
4	G50660	MEDICARE UPIN	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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