Individual
CHRISTINA N. LEITZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS BCO BADO
Contact information
Practice address
2456 NW NORTHRUP ST STE 1A, PORTLAND, OR 97210-3253
(503) 229-8490
(503) 224-0740
Mailing address
2456 NW NORTHRUP ST STE 1A, PORTLAND, OR 97210-3253
(503) 229-8490
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
—
OR
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621900001
REGENCE
OR
01
—
500647964
OMAP
OR
01
—
7760590001
MEDICARE
OR
Enumeration date
08/03/2017
Last updated
02/22/2023
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