Provider Demographics
NPI:1255375309
Name:LEAR, W. JEFFREY (MD)
Entity type:Individual
Prefix:DR
First Name:W.
Middle Name:JEFFREY
Last Name:LEAR
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 1:1086 7TH AVE SW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1997
Mailing Address - Country:US
Mailing Address - Phone:541-926-6030
Mailing Address - Fax:541-928-2942
Practice Address - Street 1:1086 7TH AVE SW
Practice Address - Street 2:SUITE 101
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1997
Practice Address - Country:US
Practice Address - Phone:541-926-6030
Practice Address - Fax:541-928-2942
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD13323207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORD73054Medicare UPIN