Provider Demographics
NPI:1619125341
Name:VANLUE, LEA DM (PA-C)
Entity type:Individual
Prefix:
First Name:LEA
Middle Name:DM
Last Name:VANLUE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1648
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97440-1648
Mailing Address - Country:US
Mailing Address - Phone:541-242-4384
Mailing Address - Fax:541-463-2820
Practice Address - Street 1:3915 RIVER RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-1230
Practice Address - Country:US
Practice Address - Phone:541-688-9140
Practice Address - Fax:541-689-0049
Is Sole Proprietor?:No
Enumeration Date:2008-09-06
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR152814363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant