Individual
COURTNEY LEIGH PHOENIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
620 NE 20TH AVE APT 421, PORTLAND, OR 97232-3544
(971) 420-7802
Mailing address
620 NE 20TH AVE APT 421, PORTLAND, OR 97232-3544
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
THW000108657
OR
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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