Individual
YESICA LEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10102 NE GLISAN ST, PORTLAND, OR 97220-4456
(503) 257-5959
Mailing address
10102 NE GLISAN ST, PORTLAND, OR 97220-4456
(503) 257-5959
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
119446
OR
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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