Individual provider Active NPI

Michael Lethin, DO

  • Student in an Organized Health Care Education/Training Program
  • Corvallis, OR
National Provider Identifier
1144849084
Registry record updated May 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
PG216312 Issued in OR
Practice address
3600 NW Samaritan Dr
Corvallis, OR 97330-5472
Phone
(541) 768-4906
NPI assigned
Apr 10, 2020
Last updated
May 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Student in an Organized Health Care Education/Training Program 390200000X PG216312 OR Primary

Addresses

Primary practice location

3600 NW Samaritan Dr
Corvallis, OR 97330-5472

Mailing address

3600 NW Samaritan Dr
Corvallis, OR 97330-5472
Phone (541) 768-4906

Other practice location 1

200 Mullins Dr
Lebanon, OR 97355-3983
Phone (503) 259-0235

Other practice location 2

400 W Mineral King Ave
Visalia, CA 93291-6237
Phone (559) 624-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230614003773 OR Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9931567419

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684627200000",
    "number": "1144849084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 NW SAMARITAN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973305472",
            "telephone_number": "541-768-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 NW SAMARITAN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973305472",
            "telephone_number": "541-768-4906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Mullins Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OR",
            "postal_code": "973553983",
            "country_code": "US",
            "telephone_number": "503-259-0235",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 W Mineral King Ave",
            "address_purpose": "LOCATION",
            "city": "Visalia",
            "state": "CA",
            "postal_code": "932916237",
            "country_code": "US",
            "telephone_number": "559-624-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LETHIN",
        "first_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-10",
        "last_updated": "2023-05-21",
        "certification_date": "2023-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": "PG216312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.