Individual
MAI P LEOPOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
10151 SE SUNNYSIDE RD STE 100, CLACKAMAS, OR 97015-5705
(503) 659-0880
(503) 513-7425
Mailing address
PO BOX 92900, PORTLAND, OR 97292-0900
(503) 659-0880
(503) 513-7425
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO12247
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060467
—
OR
01
—
130904
WA LABOR & INDUSTRIES
WA
Enumeration date
04/13/2006
Last updated
08/19/2020
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