Individual
BRIAN A LEAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6111 NE CORNELL RD, EYE HEALTH NORTHWEST, HILLSBORO, OR 97124-5410
(503) 846-9400
(503) 846-9500
Mailing address
11086 SE OAK STREET, EYE HEALTH NORTHWEST, MILWAUKIE, OR 97222
(503) 344-5102
(503) 344-5110
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3300ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500607965
—
OR
Enumeration date
08/24/2006
Last updated
11/17/2009
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