Individual
TIANNA MARIE LEITCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8007
Mailing address
3939 S BOND AVE APT 218, PORTLAND, OR 97239-4663
(208) 791-9652
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0019201
OR
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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