Individual
ELIZABETH LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1060 WEBBER ST, THE DALLES, OR 97058-3749
(541) 296-5452
Mailing address
1060 WEBBER ST, THE DALLES, OR 97058-3749
(541) 296-5452
(541) 296-1537
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
911797454
—
OR
Enumeration date
01/27/2017
Last updated
03/17/2024
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