Individual
LEON QUINTON COLBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
10000 SE MAIN ST, SUITE 365, PORTLAND, OR 97216-2448
(503) 261-4430
(503) 261-4436
Mailing address
PO BOX 92900, PORTLAND, OR 97292-0900
(503) 261-4430
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00171
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500602877
—
OR
Enumeration date
08/11/2005
Last updated
10/03/2013
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