Provider Demographics
NPI:1659391233
Name:FRANSON, LESLIE O (DPM)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:O
Last Name:FRANSON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 NE 122ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-1914
Mailing Address - Country:US
Mailing Address - Phone:503-255-1381
Mailing Address - Fax:503-255-1208
Practice Address - Street 1:1701 NE 122ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-1914
Practice Address - Country:US
Practice Address - Phone:503-255-1381
Practice Address - Fax:503-255-1208
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDP00094213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR756480055OtherRAILROAD MEDICARE
OR064014Medicaid
ORDP00094OtherSTATE LICENSE NUMBER
OR756480055OtherRAILROAD MEDICARE
OR064014Medicaid
ORT67618Medicare UPIN