Larry S Lefors, D.O.
Individual provider Active NPI Family Medicine Physician · Zillah, WA
NPI 1609994342 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1609994342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 00000767 (WA)
- Practice address
- 618 Railroad Avenue
Suite a
Zillah, WA 98953-0843 - Phone
- (509) 829-5221
- Fax
- (509) 829-6411
- NPI assigned
- Mar 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00000767 | WA | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 00000767 | WA | Yes |
Addresses
Primary practice location
618 Railroad Avenue
Suite a
Zillah, WA 98953-0843
Mailing address
PO Box 843
Zillah, WA 98953-0843
Phone (509) 829-5221
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356807 | Medicaid | WA | |
| 15993 | Other | WA | LABOR AND INDUSTRIES |
Other providers in Zillah, WA
- HD Rose LLC
- Dean Albert Hill
- Katharine Lou Nadia Holmstrom
- Heather Allison Hutchinson
- Sherry Lynn Johnson
- Amber Linnemeyer
- Jordann Loehr
- Dolores Francisca Martinez
- Medstar Cabulance Inc
- Memorial Physicians, PLLC
All providers in Zillah, WA · Family Medicine Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.