Individual
ANNIE MAE LEGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
511 SW 10TH AVE, SUITE 1301, PORTLAND, OR 97205-2732
(503) 228-0155
(503) 226-8342
Mailing address
511 SW 10TH AVE, SUITE 1301, PORTLAND, OR 97205-2732
(503) 228-0155
(503) 226-8342
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01328
OR
Other
Enumeration date
02/06/2008
Last updated
12/13/2019
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