Provider Demographics
NPI:1285091975
Name:THAPE, LEONIDIS TEP
Entity type:Individual
Prefix:
First Name:LEONIDIS
Middle Name:TEP
Last Name:THAPE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:HEAP
Other - Middle Name:
Other - Last Name:TEP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RESPIRATORY THERAPY
Mailing Address - Street 1:14095 SW WALKER RD APT 78
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-1069
Mailing Address - Country:US
Mailing Address - Phone:503-862-8095
Mailing Address - Fax:
Practice Address - Street 1:14095 SW WALKER RD
Practice Address - Street 2:APT 78
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-1018
Practice Address - Country:US
Practice Address - Phone:503-862-8095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRTP101698072279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care