Individual
SOPHIA MACLEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11035 NE SANDY BLVD, PORTLAND, OR 97220-2553
(503) 258-4690
Mailing address
6525 SE 81ST AVE, PORTLAND, OR 97206-7130
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
06/04/2018
Last updated
06/04/2018
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