Individual
MRS. LEILY ESTEGHLALIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
STUDENT
Contact information
Practice address
5000 N WILLAMETTE BLVD, BC382, PORTLAND, OR 97203-5743
(503) 943-7266
Mailing address
5000 N WILLAMETTE BLVD, BC382, PORTLAND, OR 97203-5743
(503) 943-7266
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
098000406
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098000406
OREGON STATE BOARD OF NURSIN
OR
Enumeration date
09/01/2010
Last updated
09/01/2010
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