Clifford S Lance, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00028 Issued in OR

Practice address

2699 N 17TH St
Coos Bay, OR 97420-2134

Phone

(541) 266-3600

Fax

(541) 269-0708

NPI assigned

May 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Oregon Coast Spine Institute, LLC

  • Orthopaedic Surgery of the Spine Physician
  • Coos Bay, OR
  • NPI 1629098157
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407800097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2699 N 17TH ST",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202134",
            "telephone_number": "541-266-3600",
            "fax_number": "541-269-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2699 N 17TH ST",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202134",
            "telephone_number": "541-266-3600",
            "fax_number": "541-269-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCE",
        "first_name": "CLIFFORD",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA00028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "97420A004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFIC SOURCE",
            "identifier": "C105013",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerry William Lacy
• Philip Carey Lagesse, MD
• Natasha Lamar
• Tina Lamar
• Tonya Allison Lamar
• Roger Langlie
• Teresa M Lanier, MD PHD
• Edward L Lanway, D.C.
• Miguel Victor Lanza, MD
• Amy Jeannine Larsen, LMT

• Physician Assistant in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.