Otto, Lesley Nicoloff

Otto, Lesley Nicoloff is an individual health care provider with primary practice located at 9155 Sw Barnes Rd Suite 634, Portland OR 97225-6625. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery is her primary health care specialty. Otto, Lesley Nicoloff can be contacted via phone (503) 297-4123.

Contact Information

Primary practice address
9155 Sw Barnes Rd Suite 634 Portland OR 97225-6625
Phone: (503) 297-4123
Fax: (509) 297-0344
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X MD60636494 Washington
Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery 207VF0040X MD60636494 Washington
Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery 207VF0040X MD18878 Oregon
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X MD18878 Oregon

Profile Details

NPI number 1699729608
LBN Legal business name Otto, Lesley Nicoloff
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2006
Last updated Apr 27th, 2016 - about 9 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 1699729608 NPPES
Oregon MEDICAID 073122
Oregon Other MD18878
Oregon MEDICAID 2038459
Oregon MEDICAID 1699729608
Oregon Other 931237109

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