Individual
JENIFER LEAVENWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
THW-PSS
Contact information
Practice address
6605 SE LAKE RD, MILWAUKIE, OR 97222-2161
(503) 655-8471
Mailing address
13333 SW 68TH PKWY STE 320, TIGARD, OR 97223-9196
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OR
Other
Enumeration date
06/20/2025
Last updated
06/20/2025
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