Provider Demographics
NPI:1134584071
Name:LEBAG, LAHELA MATSUI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAHELA
Middle Name:MATSUI
Last Name:LEBAG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:LAHELA
Other - Middle Name:NICOLE SHIZUE
Other - Last Name:MATSUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:7650 NE SHALEEN ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97006-6764
Mailing Address - Country:US
Mailing Address - Phone:503-268-6918
Mailing Address - Fax:
Practice Address - Street 1:7650 NE SHALEEN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97006-6764
Practice Address - Country:US
Practice Address - Phone:503-268-6918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-18
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00150191835P0018X
OR15019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist