Individual
MRS. LEAH K PADACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2401 SE STARK ST, PORTLAND, OR 97214-1759
(208) 794-0439
Mailing address
2401 SE STARK ST, PORTLAND, OR 97214-1759
(208) 794-0439
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-10177854
OR
Other
Enumeration date
04/20/2016
Last updated
05/03/2017
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