Provider Demographics
NPI:1194801183
Name:STANTON, LEHLIA P (MD)
Entity type:Individual
Prefix:
First Name:LEHLIA
Middle Name:P
Last Name:STANTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LEHLIA
Other - Middle Name:P
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:77 WAINWRIGHT DR
Mailing Address - Street 2:VA MEDICAL CENTER
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-3975
Mailing Address - Country:US
Mailing Address - Phone:509-527-3453
Mailing Address - Fax:
Practice Address - Street 1:77 WAINWRIGHT DR
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-3975
Practice Address - Country:US
Practice Address - Phone:509-527-3453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2008-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD19235207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR139449Medicaid
ORH04970Medicare UPIN
OR139449Medicaid