Individual
LEANDRO ALBERTO LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
509 NE ALBERTA ST, PORTLAND, OR 97211-3976
(503) 249-7767
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/22/2013
Last updated
04/22/2013
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