NPI 1043211824

Lake Grove Ent PC

Organisation Otolaryngology Physician Lake Oswego, OR

Practice location

Address: 17704 Jean Way STE 101, Lake Oswego, OR 97035-5497
Phone: (503) 699-0370
Fax: (971) 236-9099

Authorised official

Name: Cheryl Lee Kruse
Title: Clinic Manager
Phone: (503) 699-0370

Registered specialties

Otolaryngology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Y00000X

Other Otolaryngology providers in Oregon →

Registry record

NPI: 1043211824
Entity type: Organization
NPI issued: 3 Aug 2005
Record last updated: 4 Apr 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.