Provider Demographics
NPI:1316972300
Name:LASHLEY, DAVID B (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:LASHLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2230 NW PETTYGROVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210
Mailing Address - Country:US
Mailing Address - Phone:503-223-6223
Mailing Address - Fax:503-223-3665
Practice Address - Street 1:2230 NW PETTYGROVE
Practice Address - Street 2:SUITE 210
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210
Practice Address - Country:US
Practice Address - Phone:503-223-6223
Practice Address - Fax:503-223-3665
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD188262088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR129966Medicaid
OR129966Medicaid
G65704Medicare UPIN