| Kenneth M Leclerc, MD | |
|
19250 Sw 65th Ave, Suite 265, Tualatin, OR 97062 | |
| (503) 413-7162 | |
| (503) 692-2101 |
| Full Name | Kenneth M Leclerc |
|---|---|
| Gender | Male |
| Speciality | Cardiovascular Disease (cardiology) |
| Experience | 32 Years |
| Location | 19250 Sw 65th Ave, Suite 265, Tualatin, Oregon |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760483754 | NPI | - | NPPES |
| 500685619 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RC0000X | Internal Medicine - Cardiovascular Disease | L4038 (Texas) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | MD172293 (Oregon) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Legacy Meridian Park Medical Center | Tualatin, OR | Hospital |
| Legacy Good Samaritan Medical Center | Portland, OR | Hospital |
| Legacy Emanuel Medical Center | Portland, OR | Hospital |
| Legacy Silverton Medical Center | Silverton, OR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Legacy Clinics Llc | 0244144004 | 635 |
| Legacy Good Samaritan Hospital And Medical Center | 0547179939 | 152 |
| Legacy Emanuel Hospital And Health Center | 4587573639 | 194 |
| Legacy Meridian Park Hospital | 5092609842 | 93 |
| Legacy Salmon Creek Hospital | 0446295711 | 253 |
| Entity Name | Legacy Clinics Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902827272 PECOS PAC ID: 0244144004 Enrollment ID: O20031117000089 |
| Entity Name | Legacy Good Samaritan Hospital And Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780608216 PECOS PAC ID: 0547179939 Enrollment ID: O20031125000416 |
| Entity Name | Legacy Emanuel Hospital & Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831112358 PECOS PAC ID: 4587573639 Enrollment ID: O20040127001204 |
| Entity Name | Silverton Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669424354 PECOS PAC ID: 8921901877 Enrollment ID: O20040129000172 |
| Entity Name | Legacy Meridian Park Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184647620 PECOS PAC ID: 5092609842 Enrollment ID: O20040211001181 |
| Entity Name | Legacy Mount Hood Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386919132 PECOS PAC ID: 3173515996 Enrollment ID: O20040401000550 |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth M Leclerc, MD Po Box 3777, Portland, OR 97208-3777 Ph: (503) 413-3900 | Kenneth M Leclerc, MD 19250 Sw 65th Ave, Suite 265, Tualatin, OR 97062 Ph: (503) 413-7162 |
Jaymee E Delaney, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 19260 Sw 65th Ave, Ste 270, Tualatin, OR 97062 Phone: 503-352-0770 | |
Jessica Kazue Haraga, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 19250 Sw 90th Ave, Tualatin, OR 97062 Phone: 503-692-3750 Fax: 503-691-2324 | |
Dr. Benito G Pataroque, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 6485 Sw Borland Rd, Suite D, Tualatin, OR 97062 Phone: 503-692-3647 Fax: 503-691-1670 | |
Dr. Tammi Kaye Boston, MD Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 19875 Sw 65th Ave, Suite 100, Tualatin, OR 97062 Phone: 503-692-7785 Fax: 503-885-1663 | |
Dr. William H Treuhaft, M.D. Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 6485 Sw Borland Rd, Suite F, Tualatin, OR 97062 Phone: 503-413-3650 Fax: 503-413-3644 | |
Dean Kyle Peterson, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 19300 Sw 65th Ave, Tualatin, OR 97062 Phone: 503-413-8407 Fax: 503-413-6951 | |
Dr. Mark Leo Mckinstry, MD Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 19875 Sw 65th Ave, Tualatin, OR 97062 Phone: 503-692-7785 Fax: 503-885-1663 |