Individual
LEEANN CHERYL OSBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
375 NW BEAVER ST, SUITE 101, PRINEVILLE, OR 97754
(541) 447-1680
(541) 447-4670
Mailing address
PO BOX 4228, PORTLAND, OR 97208-4228
(541) 383-3005
(541) 383-1883
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA01293
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213187
—
OR
01
—
383860
MEDICARE RHC
OR
Enumeration date
10/31/2007
Last updated
10/17/2024
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