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Individual

LEOCADIA HAINLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3034 NE MLK BLVD, PORTLAND, OR 97212-3053
(503) 889-2849
Mailing address
17097 SW GREEN HERON DR, SHERWOOD, OR 97140-8971

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
09/25/2007
Last updated
10/28/2007
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