Provider Demographics
NPI:1447403605
Name:THAMES, LEELEE KHANH-HOA (MD, MBA)
Entity Type:Individual
Prefix:MRS
First Name:LEELEE
Middle Name:KHANH-HOA
Last Name:THAMES
Suffix:
Gender:F
Credentials:MD, MBA
Other - Prefix:MRS
Other - First Name:HOA
Other - Middle Name:KHANH
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3601 SW RIVER PKWY UNIT 800
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4555
Mailing Address - Country:US
Mailing Address - Phone:832-814-4044
Mailing Address - Fax:
Practice Address - Street 1:3601 SW RIVER PKWY UNIT 800
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4555
Practice Address - Country:US
Practice Address - Phone:832-814-4044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2016-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD156937207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500646304Medicaid