| Lesley Nicoloff Otto, MD | |
|
9155 Sw Barnes Rd, Suite 634, Portland, OR 97225-6625 | |
| (503) 297-4123 | |
| (509) 297-0344 |
| Full Name | Lesley Nicoloff Otto |
|---|---|
| Gender | Female |
| Speciality | Obstetrics & Gynecology - Female Pelvic Medicine And Reconstructive Surgery |
| Location | 9155 Sw Barnes Rd, Portland, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699729608 | NPI | - | NPPES |
| 073122 | Medicaid | OR | |
| MD18878 | Other | OR | LICENSE |
| 2038459 | Medicaid | WA | |
| 1699729608 | Medicaid | WA | |
| 931237109 | Other | OR | TAX ID |
| Entity Name | Providence Health & Services Oregon |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023488343 PECOS PAC ID: 0648183608 Enrollment ID: O20031106000652 |
| Entity Name | Providence Health & Services - Oregon |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003991845 PECOS PAC ID: 5395656284 Enrollment ID: O20031113000626 |
| Entity Name | Providence Health & Services - Oregon |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114015971 PECOS PAC ID: 9335057447 Enrollment ID: O20031117000153 |
| Mailing Address | Practice Location Address |
|---|---|
| Lesley Nicoloff Otto, MD 847 Ne19th, Suite 300, Portland, OR 97232 Ph: (503) 963-2801 | Lesley Nicoloff Otto, MD 9155 Sw Barnes Rd, Suite 634, Portland, OR 97225-6625 Ph: (503) 297-4123 |
Dr. Rachel L Gutfreund, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 10101 Se Main St Ste 3001, Portland, OR 97216 Phone: 503-261-4423 Fax: 503-261-4424 | |
John Gilbert Buckmaster, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-4200 | |
Darlene J Dodson, M.D. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 9205 Sw Barnes Rd Fl 3, Portland, OR 97225 Phone: 503-216-3388 | |
Antonio E Frias, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-418-4200 Fax: 503-494-4473 | |
Sig-linda Jacobson, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 5006 Sw Martha St, Portland, OR 97221 Phone: 503-806-7854 | |
Laila Raad Sillay, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 9555 Sw Barnes Rd Ste 360, Portland, OR 97225 Phone: 503-445-0590 | |
Anuradha Devabhaktuni, Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 300 N Graham St Ste 100, Portland, OR 97227 Phone: 503-413-1122 |