Individual
LESLIE DUDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A.
Contact information
Practice address
959 NE 165TH AVE, PORTLAND, OR 97230-6148
(503) 408-4100
(503) 408-8384
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
372600000X
Adult Companion
—
—
Other
Enumeration date
07/15/2011
Last updated
09/30/2013
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