Individual
LEA MARIE LEAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4650 SW GRIFFITH DR, BEAVERTON, OR 97005-8719
(503) 684-8159
(503) 598-0934
Mailing address
4650 SW GRIFFITH DR, BEAVERTON, OR 97005-8719
(503) 684-8159
(503) 598-0934
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201500362LPN
OR
Other
Enumeration date
03/07/2016
Last updated
03/07/2016
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