Individual
TRACEY BETH LESLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
10100 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 571-8181
Mailing address
10100 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2128
OR
Other
Enumeration date
08/31/2006
Last updated
12/29/2021
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