Basic Information
| Provider Information | |||||||||
| NPI: | 1467496521 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAPIDUS | ||||||||
| FirstName: | ALEXANDER | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9340 SW BARNES RD | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972256623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8886330087 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10150 SE 32ND AVE | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972226516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5035131031 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2006 | ||||||||
| LastUpdateDate: | 03/19/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD24662 | OR | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 8368649 | 05 | WA | MEDICAID | 200132 | 01 | WA L & I | OTHER | 297520 | 05 | OR | MEDICAID | 8906934 | 01 | WA CRIME VICTIM | OTHER | 865374000 | 01 | BCBS OF OR | OTHER |