Lacayanga, Imelda P

Lacayanga, Imelda P is an individual health care provider with primary practice located at 9427 Sw Barnes Rd Suite 396, Portland OR 97225-6652. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Lacayanga, Imelda P can be contacted via phone (503) 216-6550.

Contact Information

Primary practice address
9427 Sw Barnes Rd Suite 396 Portland OR 97225-6652
Phone: (503) 216-6550
Fax: (503) 216-6575
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD19170 Oregon

Profile Details

NPI number 1033145222
LBN Legal business name Lacayanga, Imelda P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Oct 2nd, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033145222 NPPES
Oregon MEDICAID 067546

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