Individual
STEPHEN A LEONARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2120 EXCHANGE ST STE 302, ASTORIA, OR 97103-3364
(503) 338-2993
(503) 338-2996
Mailing address
11790 SW BARNES RD STE 330, PORTLAND, OR 97225-5935
(503) 228-4414
(503) 228-7293
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA00900
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
231893
—
OR
01
—
381852
MEDICARE
OR
Enumeration date
06/14/2005
Last updated
07/23/2020
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