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Individual

MS. KATIE J LEDERLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
B.A.

Contact information

Practice address
7455 SW BEVELAND RD, TIGARD, OR 97223-8610
(503) 624-2600
(503) 624-7752
Mailing address
2148 NE 20TH AVE, PORTLAND, OR 97212-4617
(720) 938-0896

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
11/15/2007
Last updated
02/12/2010
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