Individual
LEAH PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
9427 SW BARNES RD, STE 395, PROVIDENCE MEDICAL GROUP - COLUMBIA WOMEN'S CLINIC, PORTLAND, OR 97225
(505) 722-1000
Mailing address
9427 SW BARNES RD, STE 395, PROVIDENCE MEDICAL GROUP - COLUMBIA WOMEN'S CLINIC, PORTLAND, OR 97225
(503) 216-2602
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
1964
CA
367A00000X
Advanced Practice Midwife
Primary
201406682NP-PP
OR
Other
Enumeration date
09/27/2011
Last updated
03/24/2021
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