Individual
JUSTIN LEAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
0615 SW PALATINE HILL RD, MSC 101, PORTLAND, OR 97219-7879
(503) 535-1181
Mailing address
0615 SW PALATINE HILL RD, MSC 101, PORTLAND, OR 97219-7879
(503) 535-1181
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
07/26/2007
Last updated
07/26/2007
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