Individual
MEGANNE E LEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
707 SW GAINES ST, MAIL CODE CDRCP, PORTLAND, OR 97239-2901
(503) 494-5856
(503) 494-2307
Mailing address
707 S.W. GAINES ST, MAIL CODE: CDRCP, PORTLAND, OR 97239-2984
(503) 494-5856
(503) 494-2370
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
201709698NP-PP
OR
363LP0200X
Pediatric Nurse Practitioner
RN1022483
DC
Other
Enumeration date
01/05/2007
Last updated
12/05/2017
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