Provider Demographics
NPI:1609963446
Name:LEHMAN, THEODORE HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:HENRY
Last Name:LEHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 NW LOVEJOY
Mailing Address - Street 2:#906
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97909
Mailing Address - Country:US
Mailing Address - Phone:503-289-9199
Mailing Address - Fax:503-289-8808
Practice Address - Street 1:5125 SKYLINE RD S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-9427
Practice Address - Country:US
Practice Address - Phone:503-289-9199
Practice Address - Fax:503-289-8808
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OROR MD04938208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology