| Ponderosa Medical | |
|
1558 Sw Nancy Way Suite 101 Bend OR 97702-3216 | |
| (541) 312-8679 | |
| Not Available |
| Full Name | Ponderosa Medical |
|---|---|
| Speciality | Internal Medicine |
| Location | 1558 Sw Nancy Way, Bend, Oregon |
| Authorized Official Name and Position | Gilbert B Lee (PHYSICIAN) |
| Authorized Official Contact | 5413128679 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ponderosa Medical 1558 Sw Nancy Way Suite 101 Bend OR 97702-3216 Ph: (541) 312-8679 | Ponderosa Medical 1558 Sw Nancy Way Suite 101 Bend OR 97702-3216 Ph: (541) 312-8679 |
| NPI Number | 1710931274 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710931274 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD12002 (Oregon) | Primary |
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