Provider Demographics
NPI:1063650539
Name:LEKAS, GREG (DC)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:
Last Name:LEKAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 SW 12TH AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2046
Mailing Address - Country:US
Mailing Address - Phone:503-279-0205
Mailing Address - Fax:503-279-0206
Practice Address - Street 1:1201 SW 12TH AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2046
Practice Address - Country:US
Practice Address - Phone:503-279-0205
Practice Address - Fax:503-279-0206
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor