Basic Information
Provider Information
NPI: 1316975121
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROBINSON
FirstName: DANNY
MiddleName: LEE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3181 SW SAM JACKSON PARK RD
Address2: UHS-2
City: PORTLAND
State: OR
PostalCode: 972393011
CountryCode: US
TelephoneNumber: 5034944910
FaxNumber:  
Practice Location
Address1: 3181 SW SAM JACKSON PARK RD
Address2: UHS-2
City: PORTLAND
State: OR
PostalCode: 972393011
CountryCode: US
TelephoneNumber: 5034944910
FaxNumber: 5034948368
Other Information
ProviderEnumerationDate: 06/29/2006
LastUpdateDate: 12/08/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XMD19153ORN Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP3000XMD19153ORY Allopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology

ID Information
IDTypeStateIssuerDescription
07006505OR MEDICAID


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