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Lesley Nicoloff Otto, MD
Gynecology Physician in Portland, Oregon
NPI 1699729608

Lesley Nicoloff Otto is a Gynecology Physician based in Portland, OR and is specialized in Gynecology. Lesley Nicoloff Otto practices in Portland, OR and has the professional credentials of MD. The NPI Number for Lesley Nicoloff Otto is 1699729608 and holds a License No. MD60636494 (Oregon).

The current practice location address for Lesley Nicoloff Otto is 9155 Sw Barnes Rd, Portland, OR and can be reached out via phone at 503-297-4123 and via fax at 509-297-0344. You can also correspond with Lesley Nicoloff Otto through the mailing address at 847 NE19TH, PORTLAND, OR - 97232 (mailing address contact number: 503-963-2801).

Location: 9155 Sw Barnes Rd, Portland, OR, 97232
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Provider Profile Details
NPI Number
1699729608
Provider Name
Lesley Nicoloff Otto
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
9155 Sw Barnes Rd, Portland, OR, 97232
Phone Number
503-297-4123
Fax Number
509-297-0344
Provider Enumeration Date
05/22/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
073122 05 OR
MD18878 01 OR LICENSE
2038459 05 WA
1699729608 05 WA
931237109 01 OR TAX ID
institution
Provider Business Practice Location Address Details
Address
9155 Sw Barnes Rd
City
State
Zip
97225-6625
Phone Number
503-297-4123
Fax Number
509-297-0344
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Provider Business Mailing Address Details
Address
847 Ne19Th
City
State
Zip
97232
Phone Number
503-963-2801
Fax Number
503-963-2825
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Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Obstetrics & Gynecology
Speciality
Female Pelvic Medicine and Reconstructive Surgery
Taxonomy
License No.
MD60636494 (Washington)
Definition
A subspecialist in Female Pelvic Medicine and Reconstructive Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Obstetrics & Gynecology
Speciality
Gynecology
Taxonomy
License No.
MD60636494 (Washington)
Definition
Definition to come...
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