Provider Demographics
NPI:1902012479
Name:LINCOLN, DOUGLAS RONALD III (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:RONALD
Last Name:LINCOLN
Suffix:III
Gender:M
Credentials:MD, MPH
Other - Prefix:
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Mailing Address - Street 1:9300 SE 91ST AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-3762
Mailing Address - Country:US
Mailing Address - Phone:503-261-1171
Mailing Address - Fax:503-257-3963
Practice Address - Street 1:9300 SE 91ST AVE STE 200
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086
Practice Address - Country:US
Practice Address - Phone:503-261-1171
Practice Address - Fax:503-257-3963
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD151153208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics